The attractiveness of jobs in the German care sector: results of a factorial survey

Abstract

The skilled labour shortage in nursing is an issue not unique to Germany. Unattractive characteristics of nursing jobs are one reason for the low supply in nursing personnel. In our study, we analyse the influence of job characteristics on the attractiveness of nursing jobs. We address this issue via factorial survey analysis, an experimental method particularly suited to assessing personal opinions and less prone to social desirability bias than standard interview methods. Around 1300 (current and former) nurses in a distinct region in Germany were asked to rate a set of synthetic job postings, each of which contained information on 9 systematically varied job characteristics. We find that, first, attractiveness of care jobs is most strongly affected by rather “soft” characteristics such as atmosphere within the team and time for patients. “Hard” factors play a considerably smaller role. Second, one hard factor, contract duration, is estimated to be among the most important job factors, however. This is a remarkable finding given that nursing occupations suffer from severe skill shortages. Third, though wage has a statistically significant influence on attractiveness, enormous wage raises would be needed to yield higher attractiveness gains than the top-rated soft factors, or to compensate for less pleasant job characteristics with respect to those factors. Last, even after controlling for other job characteristics, hospital nursing is still rated as more attractive than geriatric nursing.

Nurse students’ views of factors that increase or decrease the attractiveness of the nursing profession

“…[39] Importantly, there is some evidence that appreciation is the most important factor influencing job satisfaction [40] and that the team atmosphere and having time for patients may matter more than material rewards. [19] The students in this study suggest enhancing nursing appreciation in society by increasing realistic information about nursing. For example, this image could be accomplished through informative videos or real-life case studies on social media and by sharing clients' positive experiences of effective nursing care.…”

“…[18] A recent study in Germany revealed that enormous wage raises would be needed to yield higher attractiveness gains than the so-called soft factors, or time for patients and atmosphere within the team. [19] Besides these intrinsic factors, extrinsic factors, for example, job security and employment opportunities [20] and contract duration, [19] influence career choice significantly.…”

Nurses’ Workplace Perceptions in Southern Germany—Job Satisfaction and Self-Intended Retention towards Nursing

“…We perceive a lack of time for patient care, thereby highlighting a persistent systemic issue. The NEXT study [24] and other German studies [7,31,32,49] indicate that job satisfaction in nursing can be improved, primarily in time for patients, work-life balance, and workload. Our study also reflects a gratification crisis, which is evidenced by dissatisfaction with payment and appreciation [15,25].…”

“…However, not all influential factors, like leadership, were included in our model due to limited effect sizes. Effective leadership is still crucial in nurses' retention decisions, as evidenced by other studies [10,24,32,49].…”

“…The NEXT (nurses early exit) Study, which conducted an extensive investigation in the early 2000s, revealed that a higher intention to stay in the profession correlates with perceived leadership quality [10,24]. Moreover, increased work demands and strains, such as the emotional burden of end-of-life care, are influential, thereby highlighting the importance of (soft) social aspects like team culture, company atmosphere, and sufficient time for direct patient care [25,32,49]. Nonsufficient patient time and the connected unfinished care work represent an emotional burden, thus affecting retention [50].…”