Despite the substantial amount of useful prior work on turnover among nurses, our understanding of the causal mechanisms explaining why nurses voluntarily leave their jobs is limited. The purpose of this article is to promote the development of stronger conceptual models of the causes of voluntary turnover among nurses. The author compares the nursing-specific literature to research on voluntary turnover from the general management field over the past 30 years and examines the evolution of key theories used in the nursing literature. Results of this review comparing nursing research with that in the broader field suggest that, over time, nursing research has not kept pace with conceptualizations from general management explaining why people either remain at or quit their jobs. The author argues that conceptual models of turnover among nurses can benefit significantly from drawing more effectively on particular models and concepts available in general management studies of turnover.
"Thus, staff retention of registered nurses (RNs) who are skilled for comprehensive geriatric care becomes more important. Consequently, research from different disciplines has analyzed potential pull and push forces involved in nurses' turnover (Gilmartin, 2013; Steel & Lounsbury, 2009). Many factors have been identified, e.g., environmental variables (e.g., city size), individual variables (e.g., age, professional experience), attitudinal variables (e.g., job satisfaction, commitment), work characteristics (e.g., job demands, job control), and organizational determinants (e.g., leadership behavior). "
[Show abstract][Hide abstract] ABSTRACT: We examined how care setting (working in nurses homes vs. home care) and type of ownership (profit vs. public/non-profit) of geriatric care services interact in influencing registered nurses’ turnover intention. Prior research revealed that working in profit-organizations, experiencing high job demands and low job control at work are important antecedents of nurses’ turnover intention. However, the impact of care setting on these associations is still inconclusive. We propose a new mediated moderation model predicting that adverse work characteristics promote turnover intention in for-profit services only if nurses work in nursing homes. A sample of 309 registered nurses (61.5% home care, 38.5% for-profit) participated in a cross-sectional questionnaire study. As expected, in for-profit care services nurses working in nursing homes reported higher professional leaving intentions compared to nurses in home care. A negative effect of profit-orientation, however, was not evident in home care settings. We further found that reported job control mediated this interaction effect. In addition, job demands also mediated the direct relation between both organizational context variables and turnover intentions. Thus, interventions seeking to reduce turnover should consider both care setting and type of ownership when identifying those job characteristics that are most relevant for turnover in geriatric care.
Annual Meeting of the Academy of Management, Vancouver (Canada); 08/2015
"A number of descriptive studies from different countries have used surveys to examine some of the reasons for nurse turnover [6,14,16]. However the mechanisms that underpin nurses’ decisions to leave are not well understood . "
[Show abstract][Hide abstract] ABSTRACT: This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories.
A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories.
Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options.
Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.
"We do not attempt to replicate any of these models entirely, but rather use key principles emphasized by several models including the Price and Muller (1981) model, the anticipated turnover model (Hinshaw and Atwood 1985), the unfolding turnover model (Lee and Mitchell 1994), and the absence and turnover model (Borda and Norman 1997). A recent review provides details about these models and how they have been applied in nursing (Gilmartin 2013). We view the theory of reasoned action (Fishbein and Ajzen 1975) as a common foundation of the turnover models. "
[Show abstract][Hide abstract] ABSTRACT: Objective – Investigate the effects of stress, economic factors, altruism and value congruence on intentions to leave the profession in nursing. Background – As the demand for nurses increases retaining nurses will be critical for healthcare organizations and the healthcare industry. We draw from a mature body of research on nurse retention to build the research model.
Method – We analyze data from a survey of 861 registered nurses in the southeastern United States. Structural
equation modeling was used to analyze the survey.
Results – Results confirm the importance of stress and salaries. Strong evidence supports the importance of the fit
between employer and nurse values. Finally, the analysis provides unexpected evidence of the reduction of
opportunities nurses have to fulfill altruistic desires at work.
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