ion rates among enrolled students (Parkes, 1982).
As the preceding discussion indicates, the shortage of professional nursing personnel is a serious but relative straightforward phenomenon. The underlying causes of this problem, however, are numerous, interrelated, and complex.
Burn out is a relatively common phenomenon in many fields of endeavor; however, it is particularly acute in the field of professional nursing (Wandelt, 1981). Burn out, together with the actions of personnel before this point is reached, lead to high rates of personnel turnover, decreased levels of produc tivity, and declining quality levels in duty performance. 3These factors cause severe managerial problems for health care delivery institutions, increased patient risk, and significant disruptions in the lives of the professional nurses involved.
Burn out is a manifestation of low levels of job satisfac tion. Job satisfaction is the product of the combined effects of a number of variables. The combination of the variables involved, to some extent, depends upon the particular job. In many instances, formal educational attainment has been linked to job satisfaction (Raelin, 1984). While formal educational attainment has not been linked directly to job satisfaction among professional nurses, it has been linked to the status accorded to nurses by other health care professionals, and to the quality of job performance, each of which affects job satisfaction (DeBack, & Mentkowski, 1986).
Nurses have traditionally taken quite seriously their com mitment to the general welfare of patients (Sheahan, 1983). In this context, the traditional attitude of nurses has been that nothing may be permitted to take priority over patients' inter ests with nurses (Sargis, 1985). Thus, when professional nurses reach a point where they are dissatisfied with their job and their role, they tend to leave the profession (Beletz, 1983). This response is different fr...