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Recognizing lifestyle needs in nursing recruitment.

Salary and benefits are not the ultimate factors in attracting good nurses

If nurses are going to be mainstream providers of health care (Maraldo, 1990), there must be some definitive effort to ensure that their supply will meet the demand. To begin with, however, nurses must be willing to work in health care settings where the populations have the greatest needs for their services. One such population is the elderly. As their numbers grow, so grow their health care needs and concerns and the demand for health care workers to meet them. Yet nursing homes, an area of need, are experiencing a chronic shortage of RNs.

There are many reasons for this: Clients do not get well and go home; long-term care lacks the excitement found in acute care; there is little opportunity for advancement and little recognition and praise for the care delivered; salaries are not commensurate with responsibilities; the public image of the elderly tends to be negative; the delivery of nursing care to the aged is perceived as physically and emotionally exhausting (Blainey, 1985).

With the prevalence of such attitudes and perceptions, the future of quality long-term care seems compromised, at best. Kaiser (1974) stated that if the problems with recruitment of professional nurses to long-term care settings were not addressed and reversed, the resulting shortage would be critical. This prediction was made years ago, but today we are still experiencing a severe shortage of nurses desiring employment in long-term care.

To achieve a reversal, there is a crucial element that must be considered: lifestyle.

An individual's lifestyle is the unifying principle on which his or her behavior is based, according to Alder (Baruth & Eckstein, 1981). It defines how the individual lives, makes consumption choices, uses leisure time and pursues career goals. While this concept may not be expressed during an employment interview, it is nontheless important to the individual.

Most of the literature on employee recruitment deals with extrinsic issues as influencing factors for nurses seeking employment. The extrinsic factors cited most frequently as satisfiers for nurses when choosing specific health care areas include: the work itself, professional autonomy, good interpersonal relationships, personal growth, and task achievement. According to job satisfaction criteria, when extrinsic needs are fulfilled, the results are employee satisfaction (Felsen 1990). Job satisfaction could influence an employee's reporting-to-work performance along with the duration of employment (Price & Mueller, 1981).

Nevertheless, it has been extremely difficult for employers to learn what potential employees really want to fulfill their career needs. Managers have resorted to providing extrinsic rewards or incentives for recruitment and employment. This, in itself, has neither eliminated nor reduced the nursing shortage.

A study conducted in Maryland (Felsen, 1990) reported, however, that convenience was nurses' the primary reason for choosing positions in the long-term care facilities studied. This indicates that fulfillment of lifestyle needs was important to the nurses in this study, who did not place the same weight on altruistic employment factors as job satisfiers, since convenience tends to fulfill lifestyle demands. This raises a significant consideration for managers depending on professional criteria rather than personal needs to promote nurses' job satisfaction.

This ties in with sociodemographic data relating to prospective nurse employees. The average RN employed in long-term care settings is married, female, Caucasian, a diplomate, and with an average age of 40 (Felsen, 1990). Combining both lifestyle needs and sociodemographic information presents the picture of a second wage earner, who views employment in long-term care as a way of fulfilling home lifestyle needs.

Middle-aged long-term care professionals are likely to require different benefits to meet their lifestyle demands, and recruitment should focus on those benefits. Examples are help with geriatric care for aging relatives, either through respite care or day care; good retirement benefits that are available with a shorter invested timeframe; and vacation time and routine perks -- salaries, hours, autonomy, etc. -- comparable to other health care workers of equal education and years of practice.

Long-term care employers also need to turn their attention to the younger professional nurses. Benefits for this potential employee must focus on child care, liberal leave policies for family matters and convenience in travel time. This population usually consists of second wage earners in the family who are working for the "extras" in lifestyle (Felsen, 1990). With the primary wage-earner already covered, benefits such as health or life insurance may not be wanted or needed by this prospective employee.

Other options to meet lifestyle demands include split shifts, 10- and 12-hour shifts and weekend alternatives. Having the nurses themselves handle all staffing emergencies, based on the principle of shared governance and fiscal responsibility, could eliminate the need for temporary staffing to cover these adjustments.

In conclusion, managers should consider promoting job satisfaction based on prospective nurses' personal needs rather than professional criteria. External attractions such as benefits are not likely, in themselves, to succeed in meeting the demands women face as wives, mothers, homemakers and health care providers. Fulfilling lifestyle needs or reducing the stress of lifestyle demands imposed by the work environment may be the new attractions for professional nurses seeking job satisfaction in long-term care.


Baruth L, Eckstein D. Theory, practice and research (2nd Ed.). Iowa: Kendall/Hunt Publishing Co., 1981.

Blainey CG. Six steps to personal fulfillment in nursing. Nursing Management 1985;169(2):37-38.

Burns-Tisdale S, Goff WF. The geriatric nurse practitioner in home care: Challenges, stressors, and rewards. The Nursing Clinics of North America 1989;24(3):809-818.

Christ MA, Hohlock FJ, Gerontologic Nursing. Pennsylvania: Springhouse Publishing Co., 1988.

Felsen LC. Perceptions of professional nurses that may influence their selecting long-term care settings for employment. Unpublished doctoral dissertation, Columbia Pacific University, California, 1990.

Fisk CF. Proceedings of the Surgeon General's Workshop on Health Promotion and Aging, 5-9. Washington, DC: Henry J. Kaiser Family Foundation, 1988.

Kaiser EM. Recruiting for the future: Long-term care nursing. The Journal of Practical Nursing 1974;33(5):14.

Maraldo P. The nineties: A decade in search of meaning. Nursing and Health Care 1990;11(1):11-14.

Price JL, Mueller CW. Professional Turnover: The Case of Nurses. New York: SP Medical and Scientific Books, 1981.
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Article Details
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Title Annotation:Nursing Care
Author:Felsen, Loree C.
Publication:Nursing Homes
Article Type:Interview
Date:Sep 1, 1993
Previous Article:Recruiting RNs to long-term care.
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