Investigation of nurses’ intention to leave: a study of a sample of UK nurses

Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis

BACKGROUND

The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs.

OBJECTIVE

This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program.

METHODS

A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework.

RESULTS

A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness.

CONCLUSIONS

Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.

The Effect of Work Engagement and Perceived Organizational Support on Turnover Intention among Nurses: A Meta-Analysis Based on the Price–Mueller Model

Aim. To elaborate on the relationship between work engagement, perceived organizational support, and the turnover intention of nurses by analysing some potential moderators. Background. Nurses’ turnover intention is negatively impacted by their level of work engagement and perceptions of organizational support. However, it is challenging to reach a consistent conclusion. Methods. Data were acquired from six electronic databases. Each study was evaluated using the quality assessment tool for cross-sectional studies of the Agency for Healthcare Research and Quality (AHRQ). STATA 15.0 was used to analyse the data, and a random effects model was used. The groups that included two or more studies were added to the moderator analysis. Results. A total of 40 study articles involving 23,451 participants were included. The turnover intention of nurses was inversely associated with work engagement (coefficient: −0.42) and perceived organizational support (coefficient: −0.32). A substantial moderating role was played by cultural background, economic status, working years, and investigation time ( $P<0.05$ ). Conclusion. Work engagement and organizational support significantly reduced turnover intention among nurses. Considering the acute shortage of nurses worldwide, nurses with lower wages, fewer working years, and lower levels of work engagement should be given more attention and support from their organizations. Implications for Nursing Management. The meta-analysis suggested that managers should give their employees a more organizational support and promote their work engagement to motivate nurses’ retention intention and maintain a stable workforce with little employee turnover.

The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals

The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.

Requested to do right things excessively: how citizenship pressure/future focus influence health-related work outcomes in health organizations during the pandemic

PURPOSE

Public health practitioners face citizenship pressure when requested to engage in more extra-roles behaviors during the pandemic. The purpose of the study is to reveal the potential influence mechanism of citizenship pressure on the health and work outcomes of practitioners.

DESIGN/METHODOLOGY/APPROACH

The authors completed a three-wave survey from a public healthcare organization during the coronavirus disease 2019 (COVID-19) delta-variant epidemic.

FINDINGS

Results of polynomial regression and response surface showed that increased (versus decreased) and consistently high (versus low) level of citizenship pressure induced citizenship fatigue, which in turn increases negative affect/turnover intention. These negative effects of citizenship pressure are weaker among practitioners with a higher level of future focus.

PRACTICAL IMPLICATIONS

Providing counseling service to health care practitioners in adopting a future time perspective of citizenship behaviors is important for public health organizations.

ORIGINALITY/VALUE

This study is among the earliest attempts to reveal the potential dark side of excessive request of conducting organization citizenship behavior which is more commonly seen within public health organizations in the context of pandemic.

The role of empowering leadership and psychological empowerment on nurses’ work engagement and affective commitment

Purpose

This study aims to investigate to role of empowering leadership and psychological empowerment on nurses' work engagement and affective commitment.

Design/methodology/approach

Self-administered questionnaire data from 231 nurses working in a university hospital in Saudi Arabia were analysed using a cross-sectional research design using structural equation modelling (SEM) to assess the relationship between empowering leadership (EL), affective commitment (AC) and work engagement (WE) while testing for the mediating role of psychological empowerment (PE).

Findings

SEM analysis demonstrated that EL significantly relates to AC. AC similarly significantly relates to WE. Further, the results showed that PE substantially mediates the relationship between EL and WE. There is no significant direct relationship found between EL and WE.

Practical implications

The study findings are essential for nursing managers. They illustrate that nurses become more committed to their organisation and, in return, more engaged with their work when they receive EL. Therefore, nursing managers could train their leaders to practice EL as increased WE has been found to result in other positive work attitudes such as reduced turnover intention.

Originality/value

This study corroborates the relationships between EL, AC and WE, as well as the mediating role of PE. However, this research is unique as the long-established relationship between EL and WE was not supported. It shows that the propositions of leader-member exchange theory may not hold for unique non-Western contexts, in this case, Saudi Arabia.

The Quality of the Supervisor-Nurse Relationship and Its Influence on Nurses' Job Satisfaction

BACKGROUND

Leader-Member Exchange theory provides strategic information about how to improve the leader's role and nurses' satisfaction on healthcare organizations.

OBJECTIVES

The main objective of this research was to study the quality of the supervisor-nurse relationship in relation to the nurses' job satisfaction. This research also analyses how the relationship between Leader-Member exchanges and nurse job satisfaction could be moderated by other variables, such as nurse psychological empowerment, nurse-perceived organizational support and Leader-Leader Exchange.

METHODS

The sample comprises of 2541 registered nurses who work in public hospitals in the Autonomous Region of Aragon (Spain). Regression analyses were conducted.

RESULTS

The statistically significant results demonstrate the influence that the supervisor's leadership exerts on the job satisfaction of the nurse.

CONCLUSIONS

The moderating variables (Empowerment, Perceived Organizational Support and Leader-Leader relationship) play an important role explaining the job satisfaction of the nurse. Deepening in these relationships could help us implement precise strategies to improve the nurse organizational commitment and the quality of health care performance.

Workplace bullying and turnover intentions of nurses: the multi-theoretic perspective of underlying mechanisms in higher-order moderated-serial-mediation model

PURPOSE

This study examines the relationship between workplace bullying (WPB) and the turnover intentions (TIs) of nurses, both directly and indirectly, i.e. through serial mediation of psychological contract violation (PCV) and poor employee wellbeing (EWB). And that with the moderating effect of servant leadership (SL) on its final path to TIs of nurses.

DESIGN/METHODOLOGY/APPROACH

A total of 285 nurses voluntarily participated in the survey through convenient sampling from 13 different district hospitals. The authors performed partial least squares structural equation modeling (PLS-SEM) to test the study's measurement and structural models.

FINDINGS

Overall, results indicated 62% prevalence rate of WPB and TIs of nurses had 67% variance explained by the exogenous factors. Workplace bullying was found to have direct as well as indirect relationship with TIs of nurses. For the latter, PCV and poor EWB were found to have partially mediated, both singly and serially. The moderating effect of SL on the serial mediation pathway was negative and significant.

ORIGINALITY/VALUE

Drawing on a tripartite theoretical perspective, this study illuminates the mechanism underlying WPB-TIs relationship with an advanced multivariate statistical technique in the nursing work setting in a developing country.

Exploring the mediating role of flexible working hours in the relationship of supervisor support, job and life satisfaction: A study of female nurses in China

Aims

To examine the mediating role of flexible working hours on the relationship between supervisor support, job and life satisfaction among female nurses in China.

Design

A cross‐sectional, quantitative study was conducted with online survey questionnaires.

Methods

Convenience sampling was implemented with 171 female nurses from two tertiary public hospitals in 2019.

Results

The mediation analysis demonstrates that flexible working hours significantly and positively mediate the relationship between supervisor support to job (β = 0.775, p < .001) and life satisfaction (β = 0.745, p < .001). In addition, supervisor support and flexible working hours significantly and positively influence job (r = 0.520, p < .01; r = 0.520, p < .01) and life satisfaction (r = 0.487, p < .01; r = 0.487, p < .01). The study suggested that flexible working hours iarean indicator of what supervisor support (r = 0.656, p < .01) is to improve nurses’ job and life satisfaction. The study revealed that flexible working hours and supervisor support are crucial to female nurses who face high demands at both work and home.

Do expert clinicians make the best managers? Evidence from hospitals in Denmark, Australia and Switzerland

Introduction

Hospital quality rests on the morale and productivity of those who work in them. It is therefore important to try to understand the kinds of team leaders that create high morale within hospitals.

Methods

This study collects and examines data on 3000 physicians in hospitals from Denmark, Australia and Switzerland. It estimates regression equations to study the statistical predictors of levels of doctors’ job satisfaction, their intentions to quit or stay in their current hospital and their assessment of the leadership quality of their immediate manager. A particular concern of this study is to probe the potential role played by clinical expertise among those in charge of other physicians.

Results

When led by managers with high clinical expertise, hospital physicians are (1) more satisfied with their jobs, (2) more satisfied with their supervisors’ effectiveness and (3) less likely to wish to quit their current job. These findings are robust to adjustment for potential confounders, including age and job seniority, and pass a variety of statistical checks (including clustering of SEs and checking for omitted variable bias). They are replicated in each of the three nations.

Conclusion

Physicians are happier with their jobs when led by outstanding clinical experts. It is not sufficient, it appears from this evidence, for leaders merely to be clinicians. This suggests that—though only an idealised and presumably infeasible randomised experiment could allow complete certainty—there is a natural case for managers within a hospital hierarchy to be drawn from the ranks of those who are themselves outstanding clinicians.

Nursing turnover intentions: The role of leader emotional intelligence and team culture

AIM

To explore the influence of leader emotional intelligence on the working culture prevailing in teams that ultimately impacts nurses' intent to leave the job.

BACKGROUND

Global shortages of nursing professionals have been concerning issues of extreme vitality in the delivery of superior services. Though the state-of-the-art system provides relief, the hospital management continued worrying about losing highly skilled nursing professionals due to a higher level of emotional exhaustion exhibiting progressive turnover.

METHODS

A survey technique was employed for data collection from nurses. Further data were analysed by structural equation modelling in the light of 313 substantial responses by using SmartPLS.

RESULTS

The findings revealed that leader emotional intelligence impulses critical constructive effects by fulfilling the needs of nurses and has an impact on their turnover intentions simultaneously.

CONCLUSION

The research provides an empirical lens of leadership and culture, which noticeably explain turnover intention. This study affirmed solid connections amongst the leader emotional intelligence, team culture and turnover intentions.

IMPLICATIONS FOR NURSING MANAGEMENT

The study provides valuable insight for health management organisations to focus on factors that decrease the turnover intention of nurses. Considering a global shortage of nurses, nursing management must consider crucial aspects of the work environment and plan interventions to restrain nursing turnover intentions.

The Correlation between Leader-Member Exchange and Organisational Commitment among Spanish Registered Nurses: The Moderating Role of Sex and Hospital Size

The role of the supervisor in hospitals is to oversee and encourage the active work participation of registered nurses. In this context, leadership should be focused on the creation of a positive environment for the generation of high-quality care and the development of attitudes that have a beneficial influence on the work of the registered nurse. The aims of this study have been: (i) To verify if the quality of the supervisor-nurse interpersonal relationship was correlated with organisational commitment; (ii) to establish if the correlation could be moderated by empowerment, perceived organisational support, and leader-leader exchange. A cross-sectional survey with self-report questionnaires was performed. A total of 2541 registered nurses from nine public hospitals participated in the study. They completed scales measuring leader-member exchange, commitment, empowerment, perceived organisational support, and leader-leader exchange. There was a positive correlation between the quality of the leader-member exchange and commitment. Leader-leader exchange has a moderating effect on this relationship. The moderating effects of empowerment, perceived organisational support, and leader-member exchange on the supervisor-nurse interpersonal relationship and the nurse's organisational commitment are influenced by sex and/or hospital size. Organisations should design supervisor training strategies aimed at establishing high-quality supervisor-nurse interpersonal relationships.

The Impact of Perceived Organizational Support (POS) for Increasing the Intention to Stay: A Systematic Review

Background: Nurse turnover is a problem that occurs in hospitals. The high turnover of nurses in health facilities can have a negative impact on the needs of the patients and on the quality of the health services. The turnover of nurses thus becomes a serious challenge to the efficiency, effectiveness and productivity of the health services. The aim of the systematic review was conducted to examine the impact of perceived organization support when it came to increasing the intention to stay.Method: A systematic search was conducted using articles from Scopus, Science Direct and SAGE. The search identified 15 original articles and full texts published between 2014 and 2019.Result: Nurses with high perceived organizational support with their organization have a lower intention to leave the organization. POS is the key predictor of turnover intention.Conclusion: POS can reduce turnover, especially for nurses. The positive perception of the organization can decrease turnover intention. POS that is felt strongly will affect the work performance of the nurses by increasing their intention to stay. This can the reduce hospital costs when it comes to having to recruitment new nurses.

The orientation and attitudes of intermediate vocational trained nursing students (MBO-V) towards their future profession: A pre-post survey

Students' perceptions of nursing influence recruitment and retention in nursing education. Nursing education in the Netherlands differentiates two levels: Bachelor's (HBO-V) and intermediate vocational (MBO-V) level training, with MBO-V students accounting the majority. To avoid the expected nursing shortages, these students' perceptions of nursing need to be explored. We aimed to examine the orientation and attitudes of MBO-V students towards their future profession and their relation to demographic characteristics. A descriptive survey with a pretest-posttest design was conducted. Newly enrolled MBO-V students completed a questionnaire at the beginning and after five months of education, consisting of the Nursing Orientation Tool, the Nursing Attitude Questionnaire and demographic characteristics. The Wilcoxon signed-rank test, Mann-Whitney U test and regression analysis were used for data analyses. At the first time point, students agreed most with statements related to caring, nursing expertise, advocacy, empathy, and knowledge. After five months, students were more life-oriented, while caring, nursing expertise, advocacy, and empathy decreased. Selecting nursing as a first-choice programme and aiming for a nursing career influenced students' orientation and attitudes towards nursing positively. Being aware of students' orientation and attitudes towards nursing can help nursing educators in recruitment and retention strategies.

The importance of contextual, relational and cognitive factors for novice nurses' emotional state and affective commitment to the profession. A multilevel study

AIM

This study explored the effects of contextual, relational and cognitive factors derived from novice nurses' work experiences on emotions and affective commitment to the profession.

BACKGROUND

With an increasing demand for well-trained nurses, it is imperative to investigate which work-related factors most affect their commitment to develop effective strategies to improve work conditions, work satisfaction and emotional attachment.

DESIGN

A repeated measures within subjects design.

METHODS

From September 2013-September 2014 eighteen novice nurses described work-related experiences in unstructured diaries and scored their emotional state and affective commitment on a scale. The themes that emerged from the 18 diaries (with 580 diary entries) were quantified as contextual, relational and cognitive factors. Contextual factors refer to complexity of care and existential events; relational factors to experiences with patients, support from colleagues, supervisors and physicians; cognitive factors to nurses' perceived competence.

RESULTS

The first multilevel regression analysis, based on the 18 diaries with 580 entries, showed that complexity of care, lack of support and lack of competence were negatively related to novice nurses' affective commitment, whereas received support was positively related. The next multilevel regression analyses showed that all contextual, relational and cognitive factors were either related to negative or positive emotions.

CONCLUSION

To retain novice nurses in the profession, it is important to provide support and feedback. This enables novice nurses to deal with the complexity of care and feelings of incompetence and to develop a professional commitment.

Brazilian nursing professionals: leadership to generate positive attitudes and behaviours

PURPOSE

This paper aims to identify the kind of work environment that should be offered by hospital leaders to their nursing staff in Brazil to generate job satisfaction, organizational commitment and organizational citizenship behaviour within their field of expertise.

DESIGN/METHODOLOGY/APPROACH

A survey was applied to 171 nurses and 274 nursing technicians who work at five private hospitals in Brazil. Both factor analysis and regression analysis were used to analyse the study model.

FINDINGS

The results indicate that to stimulate positive behaviours and attitudes among nursing staff, managers should mainly be concerned about establishing a clear and effective communication with their professionals to ensure role clarity, promote a good working environment and encourage relationships based on trust.

RESEARCH LIMITATIONS/IMPLICATIONS

The limitations of the study are absence of the researcher while the questionnaires were filled out and the fact that the sample comprised respondents who made themselves available to participate in the research.

PRACTICAL IMPLICATIONS

This study contributes to elucidate the factors that can promote a good internal climate for nursing staff, assisting hospital leaders to face the huge managerial challenges of managing, retaining and advancing these professionals.

ORIGINALITY/VALUE

The findings contribute to the body of knowledge in leadership among nursing professionals in developing countries. Hospital leaders in Brazil should encourage trusting relationships with nursing professionals through clear, effective and respectful communications, besides investing in team development and promoting a good working environment.