Effects of organizational commitment, job satisfaction and workplace violence on turnover intention of emergency nurses: A cross-sectional study

Prevalence of turnover intention among emergency nurses worldwide: a meta-analysis

AIM

To explore the prevalence of turnover intentions among emergency nurses across the globe, decision-makers should be offered evidence-based assistance.

BACKGROUND AND INTRODUCTION

Compared with those of general nurses, the unique work environment and pressure significantly impact emergency nurses' turnover intention. High personnel turnover intention often hinders the provision of high-quality emergency services.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Published and unpublished papers were identified through electronic searches of PubMed, Web of Science, EMBASE, CINAHL, and the Cochrane Library from their establishment until February 1, 2023. The literature included in this study may encompass cross-sectional studies and longitudinal studies. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies while using the tool developed by Hoy and colleagues in 2012. Stata 17.0 was used for all the statistical analyses.

RESULTS

This study included 12 articles by screening 744 articles, which included a total of 4400 nurses. All studies included in the analysis were cross-sectional. The overall prevalence of turnover intention among emergency nurses was 45%. Further analysis revealed that the turnover intention prevalence among emergency nurses in Asia was 54%, whereas in other regions, it was 38%. The turnover intention among younger nurses (61%) was significantly greater than that among older nurses (30%). Compared with the published scale, the self-developed scale resulted in a higher turnover intention rate of 52%, which was 41%.

CONCLUSION

The prevalence of emergency nurses' turnover intention is relatively high and shows an increasing trend, with noticeable variations across different regions and age groups. Notably, Asian nurses and those younger than 35.6 years exhibit a greater intention to turnover.

PATIENT OR PUBLIC CONTRIBUTION

There is no patient or public involvement, as this article is a meta-analysis.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing managers, administrators, and policymakers must recognize the seriousness of high turnover intentions among emergency nurses and develop effective prevention strategies to address this issue globally.

Workplace violence and turnover intention among Chinese nurses: the mediating role of compassion fatigue and the moderating role of psychological resilience

BACKGROUND

Workplace violence is a global public health issue and a major occupational hazard cross borders and environments. Nurses are the primary victims of workplace violence due to their frontline roles and continuous interactions.

OBJECTIVE

The present study aimed to investigate the status of workplace violence, turnover intention, compassion fatigue, and psychological resilience among Chinese nurses, and explore the mediating role of compassion fatigue and the moderating role of psychological resilience on relationship between workplace violence and turnover intention among Chinese nurses.

METHOD

A cross-sectional study was conducted among a convenience sample of clinical registered nurses from public hospitals in Changsha, Hunan, China. Data was collected through an online questionnaire, which included a demographic information form, the Workplace Violence Scale (WVS), the Turnover Intention Questionnaire (TIQ), the Compassion Fatigue Scale (CF-CN), and the Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics and correlation analysis were employed to examine the relationships among the main variables. A moderated mediation analysis was further conducted using the PROCESS macro for SPSS (Model 4 and Model 8) to examine the mediating role of compassion fatigue and the moderating role of psychological resilience.

RESULT

The present survey recruited a convenience sample of 1,141 clinical registered nurses, who reported experiencing multiple types of workplace violence during the past year. Correlation analysis revealed significant positive correlations between workplace violence and turnover intention (r = 0.466, P < 0.01) as well as compassion fatigue (r = 0.452, P < 0.01), while negative correlation between workplace violence and psychological resilience (r=-0.414, P < 0.01). Moderated mediation analysis revealed that compassion fatigue mediated, while psychological resilience moderated, the positive relationship between workplace violence and turnover intention (all P < 0.05).

CONCLUSION

This study underscores the mediating effect of compassion fatigue and the moderating role of psychological resilience in the relationship between workplace violence and turnover intention among Chinese nurses. Future efforts should be undertaken to develop effective preventive measures and intervention strategies at individual, organizational, and national levels to mitigate workplace violence and foster supportive work environment.

CLINICAL TRIAL NUMBER

Not applicable.

Work characteristics, job satisfaction and intention to leave: a cross-sectional survey of advanced nurse practitioners

BACKGROUND

Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs' job satisfaction and retention in healthcare services.

AIM

To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs.

METHODS

A total of 153 ANP's on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables.

RESULTS

Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06-1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI .92-.96, p < 0.001).

CONCLUSION

Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities.

Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review

BACKGROUND

Internationally, the emergency nursing workforce shortage is of critical concern.

AIM

To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.

METHOD

A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.

RESULTS

A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.

CONCLUSIONS

A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.

Turnover intention of nurses in public hospitals and its association with quality of working life: a cross-sectional survey in six provinces in China

Objectives

High turnover intention can exacerbate the workforce shortage of nurses. This study aimed to determine the level of turnover intention of public hospital nurses in China and its associated factors.

Methods

A cross-sectional questionnaire survey of 2,863 nurses was conducted in 48 public hospitals across six provinces in mainland China, measuring the sociodemographic (gender, age, marital status, and monthly basic salary) and work characteristics (professional title, workload, night sleep deprivation, and workplace violence) of respondents, their quality of working life (QWL), and turnover intention. Multivariate logistic regression models were established to determine the association between QWL and turnover intention after adjustment for variations of the sociodemographic and work characteristics.

Results

Overall, 42.8% of respondents reported turnover intention. Higher QWL scores (AOR = 0.824 for job and career satisfaction, p < 0.001; AOR = 0.894 for professional pride, p < 0.001; AOR = 0.911 for balance between work and family, p < 0.05) were associated with lower turnover intention. Workplace violence was the strongest predictor of higher turnover intention (AOR = 3.003-4.767) amongst the sociodemographic and work characteristics, followed by an age between 30 and 40 years (AOR = 1.457 relative to <30 years), and night sleep deprivation (AOR = 1.391-1.808). Senior professional title had a protective effect (AOR = 0.417 relative to no title) on turnover intention.

Conclusion

High levels of turnover intention are evident across China in nurses employed by public hospitals, in particular in those aged between 30 and 40 years. Low QWL and poor work environment are significant predictors of turnover intention.

The impact of meaning in life and professional happiness on the turnover intention of health care workers: a cross-sectional study from China

INTRODUCTION

The turnover and shortage of health care workers (HCWs) have been a worldwide problem for healthcare organizations. The primary aim of this study was to identify the factors influencing the intention of Chinese HCWs to leave their job, especially meaning in life and professional happiness.

METHODS

This observational cross-sectional study, conducted among 1125 full-time HCWs, assessed demographic variables, meaning in life, professional happiness, and turnover intention by a survey. The survey was distributed to HCWs in three tertiary hospitals. The data were analyzed by T-tests, ANOVA, Kruskal-Wallis tests and hierarchical linear regression model.

RESULTS

There were statistically significant differences in turnover intention of HCWs by gender, age, role, educational level, years in practice, and number of monthly night shifts. HCWs' meaning in life and professional happiness were negatively associated with the turnover intention. Furthermore, after controlling for other factors, meaning in life explained 3.7% of the turnover intention and professional happiness explained 13.4%.

CONCLUSION

In our study, positive psychological factors were related to turnover intentions. Professional happiness was the strongest predictor. Thus, health human resource managers should foster positive psychology among HCWs to reduce their turnover.

Quitting one's job or leaving one's profession: unexplored consequences of workplace violence and discrimination against health professionals

BACKGROUND

Although workplace violence and discrimination against healthcare workers are global and universal phenomena, and violence at work is recognized as a serious and growing problem, in Switzerland, hardly anything is known about the related consequences on job changes and career endings, which are two major staffing challenges present in the notoriously understaffed healthcare sector.

METHOD

Data collected from a written survey conducted among 1,840 hospital employees, of which 1,441 were health professionals, were used to evaluate and estimate the prevalence and impact of specific and cumulated forms of workplace violence and discrimination on the work climate and particularly on subsequent turnover intentions and career endings. Established multi- and single-item measures were used as predicting, intervening and outcome variables. Relative frequencies stratified for nurses, physicians and therapists were calculated to estimate and differentiate the size of the phenomena under study. Furthermore, crosstabulations, as well as multivariate regression analyses, were performed to explore the associations of interest.

RESULTS

Every fifth to sixth nurse and every seventh to eighth physician reported having had intentions to change jobs or leave the profession within the past year. These intentions become much more prevalent across all health professions when one or even two or more different forms of violence and/or discrimination at work are experienced and reported. Accordingly, the relative risks for intending to quit one's job or leave one's profession increase significantly and steadily with a growing number (1, 2 +) of different experienced forms of violence and/or discrimination at work compared to the reference group of those who are nonaffected (aOR from 2.5 up to 5.4). This fairly strong association was only slightly reduced (aOR from 2.1 to 4.0) when work climate was additionally taken into account as a potential intervening variable. Although work climate only partly accounted for the association under study, a poor work climate was an additional strong predictor and independent risk factor for intentions to turnover (aOR = 6.4) or leave the profession (aOR = 4.2).

CONCLUSIONS

Experiences of workplace violence and discrimination and the resulting poor work climate both together and independent of each other seem to be important causes of job changes and career endings among healthcare workers in Switzerland.

The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic

Objectives

Workplace violence is a major issue in society, business and healthcare settings. It adversely affects both employee safety and their ability to provide healthcare services.

Aim

This study examined the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic.

Methods

We collected data from 513 nurses. We conducted 'Process Macro' analysis. Firstly, we included three mediators in the model: job satisfaction, workplace violence and emotional exhaustion. Secondly, we used work hours and anxiety as moderators of the relationship between workplace violence and turnover intention.

Results

The findings revealed statistical significance that job satisfaction and workplace violence mediated the relationship between emotional exhaustion and nurse turnover intentions. Work hours and anxiety also moderated the relationship between workplace violence and nurses' turnover intention.

Conclusion

Respondents indicated that they were most affected by verbal violence during this time. Workplace violence is a negative factor that affects nurses' work, affecting them physically and psychologically. This occupational risk should be considered when evaluating nurses exposed to violence, as it affects job satisfaction and turnover intentions. The main theoretical contribution of this research is the identification of the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. It is clear that the research findings will be useful for healthcare professionals. The findings may have practical implications for healthcare administrators and their staff.

Does workplace violence affect healthcare workers' turnover intention?

AIMS

This study aimed to explore the association between workplace violence and turnover intention among Chinese healthcare workers and explore the role of gender as a moderator in this relation.

METHODS

A cross-sectional survey recruited 692 healthcare workers from a single center in a Chinese province. The content included a questionnaire regarding workplace violence, authoritarian leadership, and turnover intention. The moderated mediation effects were analyzed using the PROCESS tool in SPSS and bootstrap method was used to extract 5000 samples to estimate the 95% confidence interval of each effect.

RESULTS

The results indicated that the effect of workplace violence on turnover intention was mediated by authoritarian leadership. In addition, gender moderated the association between authoritarian leadership and turnover intention.

CONCLUSIONS

Healthcare worker managers should establish a workplace violence intervention system and change the leadership style of direct leaders to reduce healthcare workers' turnover intention.

Factors related to turnover intention among emergency department nurses in China: A nationwide cross-sectional study

BACKGROUND

Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied.

AIMS

The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses.

STUDY DESIGN

A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses.

RESULTS

A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p < .001), working more than 11 night shifts per month (β = 0.14, p < .01), experiencing workplace violence in the past year (β = 0.08, p < .05), and higher depressive symptom scores (β = 0.07, p < .001) positively correlated with turnover intention. More years of service (β = -0.38, p < .001) and higher organizational commitment scores (β = -0.45, p < .001) negatively correlated with turnover intention.

CONCLUSIONS

Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention.

RELEVANCE TO CLINICAL PRACTICE

To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.

Psychosocial factors associated with career success among nurses: A latent profile analysis

AIM

In this study, a person-centred approach was used to analyse career success profiles and explore the associated psychosocial factors among nurses.

DESIGN

A cross-sectional study was conducted from 15 April to 15 October 2019.

METHODS

A total of 1155 registered Chinese nurses were recruited from two general hospitals using convenience sampling. Participants completed a printed questionnaire, including the Maslach Burnout Inventory, Stress of Conscience Questionnaire, Practice Environment Scale, and Career Success Scale. Latent profile analysis and multinomial logistic regression were performed. The data were analysed with Mplus 8.3 and SPSS version 26.0.

RESULTS

Three latent profiles of career success were identified: high, moderate and low. Nurses with lower educational levels, more years of work experience, lower emotional exhaustion, higher personal achievement, lower stress of conscience and higher participation in hospital affairs were more likely to have higher career success than the other profiles.

CONCLUSIONS

Burnout, stress of conscience, practice environment, educational level and years of work experience were associated with career success among nurses. Targeting interventions may help enhance nurses' career success. Future research should combine subjective and objective indicators (salary, title and so on) to assess career success and explore other determinants for formulating interventions to enhance nurses' career success.

IMPACT

The heterogeneity and psychosocial factors associated with nurses' career success provide valuable evidence for the formulation of individualized interventions. Nursing managers should understand the importance of career success, develop interventions to reduce nurses' burnout and stress of conscience, and improve the practice environment to enhance their career success.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study was designed to examine the psychosocial factors associated with nurses' career success. The study was not conducted using suggestions from the patient groups or the public.

The relationships between organizational culture and thriving at work among nurses: The mediating role of affective commitment and work engagement

AIM

Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work.

BACKGROUND

Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross-level impact of organizational and individual characteristics.

METHODS

A cross-sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro.

RESULTS

Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment.

CONCLUSION

Our study confirmed the social embeddedness model of thriving at work by showing that both contextual and dispositional factors can influence nurses' thriving at work. Nurse leaders can foster nursing staff's thriving at work by building an inclusive work environment and by providing adequate resources to staff. Future research is needed to elaborate on employee and organizational outcomes associated with thriving at work.

IMPACT

Nurse leaders should be the advocate for nurses to improve their organizational identification, fostering their thriving at work. Individual nurses can also take an active role in developing work-related resources to sustain their thriving through self-adaption processes. Collective thriving in the nursing workforce is needed to overcome adversity and hardship in the ever-changing and increasingly demanding health care industry and to further contribute to the vitality of the broader social and public environments.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

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.

Intensive care units nurses' burnout, organizational commitment, turnover intention and hospital workplace violence: A cross-sectional study

AIMS

This study aimed to (1) assess the relationship between intensive care unit (ICU) nurses' burnout, organizational commitment and turnover intention, (2) examine the moderating effect of the organizational commitment on the relationship between ICU nurses' burnout and turnover intention, and (3) explore the prevalence and influencing factors of hospital workplace violence among ICU nurses.

DESIGN

Cross-sectional study design.

METHODS

Data were collected from August to October 2020 and a convenience sample of registered nurses was recruited. To control common method biases, one-month temporal separation, Harman's single-factor analysis and method of latent variables were adopted. The moderating effect was tested by SPSS Hayes PROCESS Macro. Chi-square and logistic regression were used to examine workplace violence data.

RESULTS

Organizational commitment (β = -.23, 95% confidence interval -.45 to -.03) and continuance commitment (β = -.15, 95% confidence interval -.24 to -.16) have negative moderation effects on the relationship between emotional exhaustion and turnover intention. 77.7% of ICU nurses experienced workplace violence, male and staff nurses, and nurses with lower professional titles and shorter working years have greater odds of experiencing this violence.

What is the impact of patient violence in the emergency department on emergency nurses' intention to leave?

AIM

To examine the impact that patient violence, experienced in the emergency department, has on emergency nurses' intention to leave their job.

BACKGROUND

Emergency departments have become known for their overcrowding, chaos, unpredictability and violence. Emergency nurses are at high risk of experiencing workplace violence, which is cited in the literature as having a direct effect on general nurses' intention to leave. A high rate of nursing turnover may lead to short staffing, jeopardize the quality of patient care and increase overcrowding and wait times.

EVALUATION

A systematic review was undertaken in CINAHL, Medline and Psych INFO databases using published data until November 2021. Six articles were included, and PRISMA guidelines were adhered it.

KEY ISSUES

Workplace violence in the emergency department had a direct impact on emergency nurses' intention to leave and decreased their job satisfaction. Verbal abuse is the most experienced form of workplace violence.

CONCLUSIONS

Workplace violence experienced by emergency nurses in the emergency department had a direct positive impact on their intention to leave and subsequently negative impact on their job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

This review may inform clinical decision-making and aid in the development of clinical practice guidelines for a workplace violence prevention programme, specific to the emergency department.

Impact of workplace violence on South Korean nurses' turnover intention: Mediating and moderating roles of depressive symptoms

AIM

To identify the mediating and moderating roles of depressive symptoms in the relationship between workplace violence and nurses' turnover intention in South Korea.

BACKGROUND

Workplace violence and depressive symptoms are known to influence turnover intentionsof employees.

INTRODUCTION

Among healthcare workers, nurses may be at the greatest risk of exposure to workplace violence because they have frequent contact with patients and families of patients. Depressive symptoms reported to be related to workplace violence are one set of factors affecting turnover intention.

METHODS

A cross-sectional study was designed and employed to investigate mediation and moderation roles of depressive symptoms between workplace violence and turnover intention.

RESULTS

Verbal violence and sexual harassment increased depressive symptoms, which in turn increased turnover intentions in a sample of Korean nurses. Depressive symptoms showed partial mediation effects between verbal violence and sexual harassment and turnover intention. Depressive symptoms showed moderating effects on sexual harassment and turnover intention.

DISCUSSION

It is necessary to reduce turnover intention not only by preventing violence but also by managing depressive symptoms in nurses who have experienced verbal violence and sexual harassment.

CONCLUSION

Depressive symptoms were shown to have a mediating and moderation roles on the relationship between WPV and turnover intention.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital managers such as hospital and nursing directors should provide effective policies to prevent verbal violence and sexual harassment to reduce turnover intention in the workplace. It is needed to educate patients and patient caregivers about the importance of preventing violence against nurses. Policies should be established to provide regular check-ups for depressive symptoms and psychological support for nurses who have experienced WPV.

The impact of the COVID-19 pandemic on the prevalence and risk factors of workplace violence among healthcare workers in China

Background

The pandemic of COVID-19 has significantly increased the burden on healthcare workers and potentially affect their risk of workplace violence (WPV). This study aimed to explore the prevalence and risk factors of WPV among healthcare workers during the peaking and the remission of the COVID-19 pandemic in China.

Methods

Using the snowball method, a repeated online questionnaire survey was conducted among Chinese healthcare workers from March 27th to April 26th in 2020 and 2021, respectively. Data included healthcare workers' socio-demographic and occupational characteristics, psychological status, and workplace violence.

Results

A total of 3006 samples in 2020 and 3465 samples in 2021 were analyzed. In 2020, the prevalence of WPV and witnessing colleagues suffering from WPV among healthcare workers were 64.2% and 79.7% respectively. Compared with 2020, the prevalence decreased by 11.0% and 14.4% in 2021, respectively. Logistic regression showed that WPV in 2020 was influenced by males, long working experience, working in the psychiatric department, direct contact with COVID-19 patients, self-discovery of medical errors, moral injury, depression, and anxiety (minimum OR = 1.22, maximum OR = 2.82). While risk factors of WPV in 2021 included males, working in psychiatric departments, self-discovery of medical errors, moral injury, depression, and anxiety (minimum OR = 1.33, maximum OR = 3.32); and protective factors were holding a master's degree (OR = 0.78) and working in other departments (OR = 0.54).

Conclusion

This study retains the common effects of WPV among healthcare workers, though after the baptism of the COVID-19 pandemic, the prevalence of WPV among healthcare workers decreased; however, part of the influencing factors changed. In addition, COVID-19 has seriously affected the mental health of healthcare workers, and the effect of mental health problems on WPV should also attract more attention.

Application of a Hybrid Multi-Criterion Decision-Making Model for Evaluation and Improvement of Nurses' Job Satisfaction

Background

The global shortage and turnover of nurses is a current challenge. Past studies have shown that nurse job satisfaction may ameliorate nurse shortage. Although there are many studies on the criteria influencing nurses' job satisfaction, few have examined the causal relationships and weight of each criterion from a systematic perspective.

Objective

Identify the key criteria and causal relationships that affect nurses' job satisfaction, and help nurse leaders identify high-weight, high-impact dimensions and contextualize them for improvement.

Methods

The study developed a hybrid multi-criterion decision-making model, which incorporated the McCloskey/Mueller satisfaction 13-item scale (MMSS-13), and the Decision-Making Trial and Evaluation Laboratory and the Importance-Performance Analysis methods the model was used to analyze key factors of nurse satisfaction and their interrelationships based on the experience of 15 clinical nurse specialists.

Results

In MMSS-13's dimension level, “satisfaction with work conditions and supervisor support” (C₅) had the highest impact, and “satisfaction with salary and benefits” (C₁) had the highest weight. In criteria level, “salary” (C₁₁), “flexibility in scheduling time off” (C₂₄), “maternity leave time” (C₃₁), “opportunities for social contact after work” (C₄₁), and “your head nurse or facility manager” (C₅₁) had high influence under their corresponding dimensions. The “benefits package” (C₁₃) was the top criterion with the highest impact on MMSS-13.

Conclusions

This study assessed nurses' job satisfaction from a multidimensional perspective and revealed the causal relationships between the dimensions. It refined the assessment of nurse job satisfaction to help nurse leaders better assess nurse job satisfaction and make strategic improvements. The study found that compensation and benefits had the highest weight in nurses' job satisfaction. Meanwhile, support for family responsibilities and working conditions, and support from supervisors were the cause dimensions of job satisfaction. Among the more detailed criteria, salary, benefits package, maternity leave time, and leadership had a greater impact on nurses' job satisfaction. Nurse leaders should start with these dimensions to achieve efficient improvement of nurses' job satisfaction.

Relationships among basic psychological needs, organizational commitment, perceived authentic leadership, and turnover intention in Korean nurses: A cross-sectional study

AIM

This study determined the relationships of satisfaction and frustration with basic psychological needs, organizational commitment, perceived authentic leadership, and turnover intention in nurses in South Korea.

BACKGROUND

Minimizing nurse turnover is essential for improving the quality of nursing care and patient safety.

METHODS

This was a cross-sectional, correlational pilot study of 216 nurses at a university hospital in South Korea. Data were collected with a self-report questionnaire, from September 1 to 15, 2020. Collected data were analyzed using SPSS 24.0.

RESULTS

Multiple regression analysis revealed that clinical experience (3 to 5 years, β=2.35, p=.019; 5 to 10 years, β=2.23, p=.026), subjective workload (severe, β= 2.10, p=.036; extreme, β=2.84, p=.005), psychological needs frustration (β=0.35, p<.001), organizational commitment (β=-0.17, p=.011), and perceived authentic nurse leadership (β=-0.14, p=.030) were found to have significant effects on nurses' turnover intention.

CONCLUSIONS

A strategy is needed for efficient nursing staffing management and reduction of nurses' turnover intentions.

IMPLICATIONS FOR NURSING MANAGEMENT

This study offers a new approach to reducing nurses' turnover. The results suggest that it is necessary to create a transparent work environment based on authentic leadership and consider individual frustrations with regard to basic psychological needs and organizational commitments.

Exploring the Relationship Between Satisfaction and Intention to Stay Among Millennial Employees

Purpose: The main purpose of the study is to investigate the relationship between job satisfaction, organizational commitment and intention to stay among the millennials working in IT organizations of North India. Research methodology: The present study has adopted descriptive research design and purposive sampling technique was used to gather data from 396 respondents with the help of a structured questionnaire. The data was analyzed using SPSS and PLS-SEM. Findings: Findings revealed that job satisfaction has a significant impact on organizational commitment (β=0.457, p&lt;0.05) and intention to stay (β=0.596, p&lt;0.05). It was also revealed that managerial support moderates the relationship between job satisfaction and intention to stay. Originality: This study is one of the few empirical studies that have investigated the perception of millennials about their intention to stay in IT sector. The study will be beneficial for the HR experts in improving the employees’ intention to stay by focusing on giving support to their employees.

Study on the associated factors of turnover intention among emergency nurses in China and the relationship between major factors

BACKGROUND

In China, the demand for emergency medical services is increasing. However, there is a shortage of nurses and a high turnover rate. The study has three purposes: (1) to investigate the turnover intention of emergency nurses in China; (2) to analyze the associated factors of turnover intention; and (3) to clarify the relationship between work stress, job burnout, perceived organization support, job satisfaction and turnover intention.

METHODS

A cross-sectional study was conducted to investigate 56 hospitals with independent emergency departments in Chongqing. A total of 522 emergency nurses were included. Descriptive statistics, One-way analysis of variance, Pearson correlated analysis and a mediation regression analysis were used to analyze the turnover intention, associated factors, and the relationship between the major study variables.

RESULTS

The score of turnover intention was 2.38 ± 0.57, and the proportion of nurses with high turnover intention was 40.61%. Age, working years in emergency department (ED), marital status, employment forms, professional title, promotion opportunities, weekly working hours, monthly night shifts and exposure to workplace violence during the year influenced turnover intention of emergency nurses. Work stress and job burnout were positively correlated with turnover intention (r = 0.189, r = 0.391), while perceived organization support and job satisfaction were negatively correlated with turnover intention (r = - 0.349, r = - 0.485). perceived organization support plays a mediating role between work stress and job burnout, between work stress and job satisfaction, and between work stress and turnover intention.

CONCLUSION

Work stress, job burnout, perceived organization support and job satisfaction are important associated factors of emergency nurses' turnover intention in China. It is suggested to take intervention measures to reduce work stress and job burnout and to improve perceived organization support and job satisfaction.

The Impact of Burnout on Emergency Nurses' Intent to Leave: A Cross-Sectional Survey

INTRODUCTION

Emergency nurses work in one of the busiest and most stressful departments in a hospital and, as such, may experience burnout more often than nurses working in other nursing units. This study examined the relationship among orientation, burnout (emotional exhaustion, depersonalization, and low sense of personal accomplishment), and intent to leave.

METHODS

A cross-sectional survey design was used. Emergency nurses who were members of the Emergency Nurses Association were invited to participate in an anonymous survey. The Maslach Burnout Inventory tool was used to explore emotional exhaustion, depersonalization, and sense of personal accomplishment. Emergency nurses' intent to leave was assessed with the Turnover Intention Scale. A logistic regression analysis was used to investigate the odds of intent to leave for those who scored at or above versus below the median on each burnout subscale.

RESULTS

The findings revealed that a formal orientation enhanced emergency nurses' sense of personal accomplishment and was associated with lower intent to leave. The odds of intent to leave were almost 9 times greater for participants with 5 or more years of experience, approximately 13 times greater for those with above-median emotional exhaustion, and more than 6 times lower for those with above-median sense of personal accomplishment.

DISCUSSION

Emotional exhaustion and low sense of personal accomplishment were key factors influencing emergency nurses' intent to leave. Emergency nurse leaders may find that a formal orientation program enhances sense of personal accomplishment and decreases intent to leave. Creating work environments to help emergency nurses find joy in their work may be critical to work-life balance and staff retention.

Workplace violence and turnover intentions among nurses: The moderating roles of invulnerability and organisational Support - A cross-sectional study

AIMS AND OBJECTIVES

To investigate whether internal and external violence are associated with turnover intentions among nurses during demanding periods of work.

BACKGROUND

Workplace violence can negatively impact upon mental and physical health and turnover intentions. Research focusing on how dimensions of workplace violence, internal versus external, influence turnover intentions and the factors that mitigate these effect is lacking.

METHODS

An online cross-sectional survey of multi-item measures was used to collect data from 462 Iranian nurses. We employed path modelling and analysed the data using SPSS and PROCESS macro. A STROBE checklist was used to report findings.

RESULTS

Both dimensions, internal and external, of violence were positively associated with turnover intentions. Moreover, perceived invulnerability and organisational support moderates this association. When individuals perceived invulnerability and perceived organisational support are high, internal violence is no longer indirectly related to turnover intentions via job satisfaction. In a similar vein, when perceived invulnerability and perceived organisational support are low, external violence is not related to intentions to quit. When perceived invulnerability and perceived organisational support are high, however, external violence is indirectly and negatively related to intentions to quit.

CONCLUSIONS

Nurses who regard themselves as invulnerable might be motivated to quit when they experience workplace violence. However, they are motivated to stay on the job when they both perceive themselves as invulnerable and the organisation as supporting.

RELEVANCE TO CLINICAL PRACTICE

Organisations should reconsider their policies and approach towards workplace violence especially during periods of intensive work.

The lived experience of workplace reciprocity of emergency nurses in the mid-Atlantic region of the U.S.: A descriptive phenomenological study

INTRODUCTION

Emergency nurses work under sometimes uncertain conditions to provide care to patients with all kinds of illnesses and afflictions from all segments of the population. Despite implications that they must work together to provide efficient and effective patient care, few studies explore reciprocal workplace relationships of emergency nurses.

AIM

This research sought to illuminate the lived experience of workplace reciprocity of emergency nurses.

METHODS

Using a phenomenological approach with snowball sampling technique, unstructured, open-ended interviews were conducted with emergency nurses in the mid-Atlantic region of the United States. The original study was conducted in 2013 (n = 9) and a replication study in 2018 (n = 7). Data were collected and analyzed using Giorgi's Phenomenological Method. Results from each study were evaluated for thematic congruence.

RESULTS

Six themes of workplace reciprocity of emergency nurses were identified for both studies: emergency department (ED) culture, balancing, technology, caring, bridging, and connection. An additional theme, bonding, was identified with the replication study.

CONCLUSIONS

Exploring workplace reciprocity of emergency nurses provided insight the influences on workplace relationships. Establishing and nurturing workplace reciprocity may create a culture of safety, connection, enhance work engagement, and influence nurse recruitment and retention.

The moderating effect of spiritual beliefs on job dissatisfaction related to the futile care

Introduction

This study aimed to assess the experience of providing futile care among intensive care unit nurses and to examine the moderating effect of spiritual beliefs on job dissatisfaction related to the sense of futile care among nurses in Intensive Care Units.

Materials and methods

The study had two phases. The first phase was a qualitative study. Twenty-two semi-structured interviews were conducted. In the second phase, we employed a cross-sectional design. The data from 236 nurses were collected using nurses’ perceptions of futile care questionnaire, Minnesota Satisfaction Questionnaire, and Spirituality and Spiritual Care Rating Scale.

Results

The main theme of the qualitative phase was a feeling of self as a useful tool in God’s hand. Sub-themes were providing care while knowing it is futile, not knowing the patient destiny, having hope for care to be fruitful, experiences patient recovery, acting to be a part of God’s plan. Futile care and job experience were two predictors of low job satisfaction. Spiritual well-being had a moderating effect and increased job satisfaction.

Conclusions

Futile care can decrease job satisfaction, while spiritual well-being can reduce its negative effect. Supporting spiritual aspects of nursing care can decrease turn-over intention among nurses.