Turnover intention and retention of newly licensed nurses in their first job: A longitudinal study

Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol

INTRODUCTION

Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada.

METHODS AND ANALYSIS

This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression.

ETHICS AND DISSEMINATION

This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.

Factors associated with practice readiness among newly qualified nurses in their first two years of practice

BACKGROUND

Newly graduated nurses undergo stress and role adjustment as they transition into practice during the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession.

OBJECTIVES

To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore.

METHODS

Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice.

RESULTS

More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii) tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03).

CONCLUSIONS

It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.

Missed Nursing Care as a Mediator in the Relationship between Career Calling and Turnover Intention

AIM

To explore the role of missed nursing care in mediating the relationship between career calling and intention to leave among nurses.

INTRODUCTION

Increasing nurse turnover is still a major concern in the global healthcare system. The most reliable indicator of turnover is turnover intention. It is crucial to understand its affecting elements to suggest measures to lower nurses' turnover intention.

BACKGROUND

Turnover intention has been linked to career calling and missed nursing care. Little empirical research has investigated the possibility that missed nursing care mediates between career calling and turnover intention.

METHODS

A cross-sectional survey of 347 nurses was conducted. The survey instruments included the General Information Questionnaire, Calling Scale, Missed Nursing Care Scale and Turnover Intention Questionnaire. Structural equation models were used to build the model. This study made use of the STROBE checklist.

RESULTS

For 43.8% of nurses, turnover intention was high or very high. Missed nursing care and turnover intention were negatively correlated with career calling. Missed nursing care and turnover intention were positively related. Missed nursing care mediated the relationship between career calling and turnover intention.

DISCUSSION

Career calling and missed nursing care can both influence turnover intention. Career calling can reduce the likelihood of turnover by preventing missed nursing care.

CONCLUSION

Missed nursing care mediated the relationship between career calling and intention to leave.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Nursing managers should improve nurses' career calling through professional education and minimize missed nursing care by using electronic nursing reminder devices to reduce turnover intention.

Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study

The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.

What are the key factors influencing newly graduated nurses' preference for choosing their workplace? A best-worst scaling approach

INTRODUCTION

The literature cites many factors that influence a nurse's decision when choosing their workplace. However, it is unclear which attributes matter the most to newly graduated nurses. The study aimed to identify the relative importance of workplace preference attributes among newly graduated nurses.

DESIGN

A cross-sectional study.

METHODS

We conducted an online survey and data were collected in June 2022. A total of 1111 newly graduated nurses in South Korea participated. The study employed best-worst scaling to quantify the relative importance of nine workplace preferences and also included questions about participants' willingness to pay for each workplace preferences. The relationships between the relative importance of the workplace attribute and the willingness to pay were determined using a quadrant analysis.

RESULTS

The order according to the relative importance of workplace preferences is as follows: salary, working conditions, organizational climate, welfare program, hospital location, hospital level, hospital reputation, professional development, and the chance of promotion. The most important factor, salary, was 16.67 times more important than the least important factor, the chance of promotion, in terms of choosing workplace. In addition, working conditions and organizational climate were recognized as high economic value indicators.

CONCLUSION

Newly graduated nurses nominated better salaries, working conditions, and organizational climate as having a more important role in choosing their workplace.

CLINICAL RELEVANCE

The findings of this study have important implications for institutions and administrators in recruiting and retaining newly graduated nurses.

Factors associated with millennial nurses' intention to pursue formal leadership roles: a cross-sectional study

PURPOSE

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

DESIGN/METHODOLOGY/APPROACH

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

FINDINGS

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses' intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

ORIGINALITY/VALUE

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses' intentions to pursue formal leadership roles.

A survival analysis approach to determine factors associated with non-retention of newly hired health workers in Iran

BACKGROUND AND AIM

One of the main tasks of the healthcare human resource management is to maintain and retain professional staff. The high level turnover of professional staff may reduce the quality of healthcare service delivery. Therefore, this study investigated the factors associated with the turnover of the newly recruited healthcare professionals using survival analysis method in Iran.

MATERIALS AND METHODS

This historical cohort analysis comprised 6811 employees who began working at Mashhad University of Medical Sciences between 2005 and 2020. Employees recruited at any of the university's units between the years 2005 to 2019 were included. We used appropriate descriptive indices and Log-rank test and the Cox proportional-hazards model to assess the staff turnover. A significance level of 0.05 was used for all tests.

RESULTS

The findings of the survival analysis showed that the probability of turnover in one year, two years, and five years of employment were 0.12, 0.16, and 0.27. Based on the findings of the Log-rank test, the probability of turnover in entire of the study period was not statistically different between male and female (p = 0.573), and likewise between employees with healthcare occupations and non-healthcare occupations (p = 0.351). Employees whose current workplace and birthplace were not similar had a significantly higher probability of turnover (p < 0.001). Accordingly, the Cox regression result showed, the risk of turnover for the singles was 1.22 times higher than the married. For the Ph.D degree was 3.23 times higher compared to those with a diploma or an associate degree, and for a bachelor's or master's degree was 2.06 times more likely to change their workplace than those with a diploma or an associate degree.

CONCLUSION

Policies promoting the recruitment of native-born professionals, given priority to the married candidates than single ones, and/or recurring candidates to pledge to stay in the locality of recruitment site can increase the staff retention and reduce the costs of staff turnover including re-hiring, initial and on-the-job training, accommodation, and other extra living consumptions away from home and family.

Inclusive leadership can improve nurses' psychological ownership and reduce their turnover intention under the normalization of COVID-19 prevention

Introduction

The COVID-19 pandemic continues to impact people's lives and professions worldwide. Chinese nurses face immense work pressure under the normalization of COVID-19 prevention and control, resulting in greater turnover intention. It is, therefore, crucial to study the mechanisms that influence the turnover intention of nurses in this situation.

Objective

Many studies have examined the impact of leadership style on nurses' turnover intention; however, few researchers have investigated this influence during the COVID-19 pandemic. Based on the leader-member exchange theory, this study empirically studied the effect of inclusive leadership on turnover intention of nurses under the normalization of COVID-19 prevention and control in China, while assessing the mediating role of psychological ownership.

Design

Cross-sectional study with multi-center data.

Participants

Two thousand, two hundred ninety-nine registered nurses from 17 hospitals in China were recruited from January to March, 2022, under the normalization of COVID-19 prevention and control in China.

Methods

A demographic questionnaire and scales of inclusive leadership, psychological ownership, and turnover intention integrated into an online survey were sent to registered nurses of different hospitals. Maximum likelihood structural equation modeling (ML-SEM) was used to analyze data.

Results

Independent variable inclusive leadership has a significant effect on the overall turnover intention of nurses, p < 0.001. The direct effect path coefficient from inclusive leadership to psychological ownership is significant, p < 0.001. The direct effect path coefficient from psychological ownership to turnover intention is significant, p < 0.001. The indirect effect path coefficient from inclusive leadership to turnover intention is significant, p < 0.001.

Conclusion

Psychological anxiety, burnout, turnover intention, and even suicidal thoughts were the main symptoms of Chinese nurses under the normalization of COVID-19 prevention and control in China. The absence of a mechanism to counteract these negative conditions may ultimately lead to personal psychological distress for nurses and collapse of the healthcare system. Inclusive leadership can improve nurses' psychological ownership level and reduce their turnover intention by treating them fairly, providing them with opportunities for self-development, paying attention to communication with them, and increasing their sense of belonging, self-efficacy, and self-identity.