Emergency Nursing Workforce, Burnout, and Job Turnover in the United States: A National Sample Survey Analysis

Published:February 06, 2023DOI:



      Few studies have examined emergency nurses who have left their job to better understand the reason behind job turnover. It also remains unclear whether emergency nurses differ from other nurses regarding burnout and job turnover reasons. Our study aimed to test differences in reasons for turnover or not currently working between emergency nurses and other nurses; and ascertain factors associated with burnout as a reason for turnover among emergency nurses.


      We conducted a secondary analysis of 2018 National Sample Survey for Registered Nurses data (weighted N = 3,004,589) from Health Resources and Services Administration. Data were analyzed using descriptive statistics, chi-square and t-test, and unadjusted and adjusted logistic regression applying design sampling weights.


      There were no significant differences in burnout comparing emergency nurses with other nurses. Seven job turnover reasons were endorsed by emergency nurses and were significantly higher than other nurses: insufficient staffing (11.1%, 95% confidence interval [CI] 8.6-14.2, P = .01), physical demands (5.1%, 95% CI 3.4-7.6, P = .44), patient population (4.3%, 95% CI 2.9-6.3, P < .001), better pay elsewhere (11.5%, 95% CI 9-14.7, P < .001), career advancement/promotion (9.6%, 95% CI 7.0-13.2, P = .01), length of commute (5.1%, 95% CI 3.4-7.5, P = .01), and relocation (5%, 95% CI 3.6-7.0, P = .01). Increasing age and increased years since nursing licensure was associated with decreased odds of burnout.


      Several modifiable factors appear associated with job turnover. Interventions and future research should account for unit-specific factors that may precipitate nursing job turnover.

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      Allison A. Norful is Assistant Professor, Columbia University School of Nursing, New York, NY. Twitter: @USNursing. ORCID identifier:


      Kenrick Cato is Assistant Professor, Columbia University School of Nursing, New York, NY. Twitter: @kenrickcato. ORCID identifier:


      Bernard P. Chang is Associate Professor, Columbia University Irving Medical Center, Department of Emergency Medicine, New York, NY. Twitter: @bernardchangMD. ORCID identifier:


      Taryn Amberson is PhD student, Department of Health Systems and Population Health, Seattle, University of Washington, WA. Twitter: @AmbersonTaryn. ORCID identifier:


      Jessica Castner is President, Castner Incorporated, 2021-2022 Academy of Medicine Distinguished Nurse Scholar in Residence, Grand Island, NY. ORCID identiafier: