Northern Ontario nurse practitioner job satisfaction and intent to leave: a constructivist grounded theory study

Abstract

The current document is a three-paper dissertation exploring northern Ontario primary healthcare Nurse Practitioners’ (NPs) job satisfaction and intent to leave. The characteristics of NP job satisfaction and intent to leave are poorly understood. The broader work on NP job satisfaction and intent to leave has relied heavily on quantitative cross-sectional methods. I decided to use qualitative methods in order to seek deeper understanding of NP job satisfaction and intent to leave. The sample for this constructivist grounded theory study included 18 primary healthcare NPs working full time in primary healthcare in Northern Ontario. Telephone interviews were conducted and transcripts were analyzed. We found that primary healthcare NP job satisfaction was dependent upon a particular mix of “satisfiers”. These satisfiers included independence and interdependence, challenging work, quiet moments, and beginnings and endings. NPs experience dissatisfaction related to role recognition, geographical distances, overwork, and feeling overwhelmed. Key features were identified as contributors to primary healthcare NP intent to leave. These included inadequate remuneration, the lack of a provincial government pension plan, the quality of their relationships with management and administration and extended benefits programs. Among those considering leaving a primary healthcare NP position, key features of a new position would include adequate remuneration, generous extended benefits, and a shorter distance from home and practice sites. Some respondents intending to leave their current practice setting identified that they would be seeking work outside of NP practice. This study served to clarify key job features and processes related to job satisfaction and intent to leave among Northern Ontario’s primary healthcare NP population. A broader theory of NP job satisfaction and intent to leave emanated from the analysis of relationships among these key concepts within the study. The findings of this study could serve to inform initiatives to retain and recruit primary healthcare NPs within both rural and urban practice settings across northern Ontario.