Nursing home staffing, turnover, and case mix

This study examined the predictors of total nurse and registered nurse (RN) staffing hours per resident day separately in all free-standing California nursing homes (1,555), using staffing data from state cost reports in 1999. This study used a two-stage least squares model, taking into account nursing turnover rates, resident case mix levels, and other factors. As expected, total nurse and RN staffing hours were negatively associated with nurse staff turnover rates and positively associated with resident case mix. Facilities were resource dependent in that a high proportion of Medicare residents predicted higher staffing hours, and a higher proportion of Medicaid residents predicted lower staffing hours and higher turnover rates. Nursing assistant wages were positively associated with total nurse staffing hours. For-profit facilities and high-occupancy rate facilities had lower total nurse and RN staffing hours. Medicaid reimbursement rates and multifacility organizations were positively associated with RN staffing hours.

Wage policy in the health care sector: a panel data analysis of nurses' labour supply

Shortage of nurses is a problem in several countries. It is an unsettled question whether increasing wages constitute a viable policy for extracting more labour supply from nurses. In this paper we use a unique matched panel data set of Norwegian nurses covering the period 1993-1998 to estimate wage elasticities. The data set includes detailed information on 19,638 individuals over 6 years totalling 69,122 observations. The estimated wage elasticity after controlling for individual heterogeneity, sample selection and instrumenting for possible endogeneity is 0.21. Individual and institutional features are statistically significant and important for working hours. Contractual arrangements as represented by shift work are also important for hours of work, and omitting information about this common phenomenon will underestimate the wage effect.

Push and pull factors in international nurse migration

PURPOSE

To describe the push and pull factors of migration in relation to international recruitment and migration of nurses.

ORGANIZING CONSTRUCT

Review of literature on nurse migration, examination of effects of donor and receiving countries, and discussion of ethical concerns related to foreign nurse recruitment.

FINDINGS

The primary donor countries are Australia, Canada, the Philippines, South Africa, and the United Kingdom (UK); the primary receiving countries are Australia, Canada, Ireland, the UK, and the United States (US). The effects of migration on donor countries include the loss of skilled personnel and economic investment; receiving countries receive skilled nurses to fill critical shortages with less economic investment. Ethical concerns include the potential for exploitation of foreign nurses.

CONCLUSIONS

Nurses migrate to seek better wages and working conditions than they have in their native countries. Given the current conditions, developed countries continue to actively recruit foreign nurses to fill critical shortages. Migration is predicted to continue until developed countries address the underlying causes of nurse shortages and until developing countries address conditions that cause nurses to leave.

[The underpaid nursing profession: myth or reality]

The originality of this research lies in its object, nurses salaries, a subject that is often discussed amongst professionals, yet rarely broached in writing. The concepts of salaries and salaried workers are examined, then, through literature, a list of salary data from 1845 to 1945 is made. The study of nursing personnel salaries from 1945 to 2001 begins with a reconstruction of salary charts, continuing with an internal analysis of the private and semi-public sector, then alternatively with the teachers. This work provides objective information on the aspect of this profession's salaries and uncovers numerous questions on the origins of wage increases.

Making it work: organization and processes of telephone nursing advice services

Efforts of health plans to balance service quality with cost control have spurred rapid growth in telephone nursing advice services. Service system design can affect costs, patient outcomes, and staff retention. Research has not addressed how the organization of nursing services affects practice outcomes in telephone advice settings. We describe observed variations in telephone advice nursing services and the organizational and process factors the nurses identified as supporting or hindering their work.

Number crunching with variable budgets

Variable budgeting allows managers to support a resource management plan that provides for efficient staffing and patient care.