Nursing without borders - how the inter-state migration of nurses affects the nursing workforce

Purpose of the project:

To examine the inter-state migration of registered nurses (RNs) and to identify what intentions RNs have to cross state borders to work.

Background and significance of the project:

Although the migration of RNs from developing to industrialized countries has been discussed widely in the literature, inter-state migration has received limited attention. This paper examines inter-state migration nationwide and uses California to better understand inter-state migration of the RN workforce.

Approach or method used in developing the project:

Data from the 2004 National Sample Survey of Registered Nurses are used to examine the demographics of nurses who moved to another state between 2003 and 2004. Nursing licensure and endorsement data from the California Board of Registered Nursing are used to measure and characterize movements of RNs. A random sample survey of 2,400 RNs who requested endorsements of their nursing licenses into or out of California was conducted in 2007 and 2008. These data are used to describe residence and employment plans of nurses. Descriptive statistics are used to describe all data.

Major outcomes:

Nationally, nurses who moved to another state within the previous year cited job stress/burnout, interest in another job, and pay/benefits as the top reasons for changing jobs. Many of the RNs who requested an endorsement of their RN license into California plan to travel to California to work. RNs who requested an endorsement of their RN license out of California reported that high cost of living, moving closer to family and friends, and trying to live elsewhere, were their primary motivations for requesting an endorsement. Many of these RNs worked as nurses in California within the past year, plan to maintain an active RN license in California, and plan to return to California.

Conclusions and implications:

Although personal factors were the most commonly reported reasons for RNs who endorsed their licenses from California to other states, policies that encourage nurses to continue practicing in their current state of licensure may help the state recruit and retain more of its nurses. As the nursing shortage continues, the inter-state migration of RNs is an important factor for states to consider when determining recruitment and retention strategies for their nursing workforce.