Leaving the organization or the profession: A multilevel analysis of nurses' intentions

School of Nursing, University of Kansas Medical Center, USA.
Journal of Advanced Nursing (Impact Factor: 1.74). 03/2010; 66(3):616-26. DOI: 10.1111/j.1365-2648.2009.05204.x
Source: PubMed


This paper is a report of a study of (i) which variables are associated with the intention to leave the profession (ii) which variables are associated with the intention to leave the organization; and (iii) how the related variables differ between intentions in a secondary analysis of data of the German part of the European Nurses' Early Exit Study.
Nursing turnover research so far rarely differentiates between leaving the profession or the organization. The identification of specific correlates for different leaving intentions would support better understanding of the turnover process and the development of targeted measures to reduce turnover.
A secondary data analysis of the German sample of the European Nurses' Early Exit-Study was performed, using a generalized linear mixed model approach.
Data from 2119 Registered Nurses in 71 departments of 16 hospitals from 2003 were analysed. Models for intentions to leave the profession explained more of the variance (r(2) = 0.46) than models for intentions to leave the organization (r(2) = 0.28). Both leaving intentions were associated with age, professional commitment and job satisfaction. Intentions to leave the profession were strongly associated with variables related to the personal background and the work/home interface whereas intentions to leave the organization were related to organizational leadership and the local context.
Retention initiatives should address the work-home interface. Surveys assessing nursing turnover should be based on comprehensive turnover definitions, including different leaving directions.

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Available from: Hans Martin Hasselhorn, Jan 18, 2014
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    • "The turnover of health-care workers and related determinants have been of interest to researchers from different disciplines for several decades (Coomber & Barriball 2007, Hasselhorn et al. 2008, Simon et al. 2010, Hayes et al. 2011). Ajzen's (1991) theory of planned behaviour has explained factors that predict actual turnover and describe the relationships between a person's attitudes, intentions and turnover behaviour . "
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    ABSTRACT: AimTo investigate the relationship between turnover intentions and job satisfaction among hospital midwives from seven countries and to determine how the related variables differ between countries.Background Studies investigating professional turnover and job satisfaction among midwives are limited in scope.MethodA cross-sectional descriptive survey was used to investigate the intended turnover and job satisfaction relationship among 1190 hospital midwives in European and Asian countries. Data were collected using a set of questionnaires that included questions regarding the leaving intentions of midwives and the McCloskey/Mueller satisfaction scale.ResultsMidwives were least satisfied with their extrinsic rewards and professional opportunities and with the balance between family and work. Significant differences were found in all domains of job satisfaction according to midwives’ intentions to leave their current workplace in hospital or profession of midwife, and to work abroad.Conclusion There are some general satisfying and dissatisfying elements for the profession of midwife across different countries.Implications for nursing managementThe results highlight the importance of understanding midwives’ leaving intentions and related factors across different countries. To prevent midwife turnover, health-care managers should gain greater insight into the early stage of midwives’ turnover intention.
    Full-text · Article · Jan 2015 · Journal of Nursing Management
    • "In a study by Lavoie-Tremblay et al. [38], those young graduates (24 or younger) who reported having poor work environment, were more likely to state they would leave the profession. Most of the earlier turnover research is concerned with nurses leaving the job or the organization [27]; less research is conducted on what motivates nurses to leave their profession [11] [25]. This is understandable, because nurse turnover is expensive and organizations are usually more concerned with their own nursing manpower than workforce in a whole [11]. "
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    ABSTRACT: AimTo describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession.Background Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession.DesignAn in-depth, descriptive approach was adopted.Method Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: ‘Why had the young registered nurses left their previous organisation?’ and ‘Why do young registered nurses have an intention to leave the profession?’ResultsThe findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a ‘second best’ or serendipitous career choice.Conclusions The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys.Implications for nursing managementYoung registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition.
    No preview · Article · Aug 2014 · Journal of Nursing Management
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    • "The lack of attention to consider the group as a level for analysis in organisational studies has been criticised by many researchers (Schriesheim et al. 1999) and recently this approach has been applied in nursing studies (Caldwell et al. 2009, Simon et al. 2010). To date, turnover studies have limited their focus to the individual level, paying little attention to the potential effects of multilevel factors (Holtom et al. 2008). "
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    ABSTRACT: To analyse nursing turnover intention from the unit by using multilevel approach, examining at the individual level, the relationships between job characteristics, job satisfaction and turnover intention, and at the group level the role of leader-member exchange. Research on nursing turnover has given little attention to the effects of multilevel factors. Aggregated data of 935 nurses nested within 74 teams of four Italian hospitals were collected in 2009 via a self-administered questionnaire. Hierarchical linear modelling showed that job satisfaction mediated the relationship between job characteristics and intention to leave at the individual level. At the unit level, leader-member exchange was directly linked to intention to leave. Furthermore, cross-level interaction revealed that leader-member exchange moderated the relationship between job characteristics and job satisfaction. This study supported previous research in single-level turnover studies concerning the key role of job satisfaction, providing evidence that job characteristics are important in creating motivating and satisfying jobs. At the unit-level, leader-member exchange offers an approach to understand the role of unit-specific conditions created by leaders on nurses' workplace wellbeing. This study showed that it is important for nursing managers to recognise the relevance of implementing management practices that foster healthy workplaces centred on high-quality nurse-supervisor relationships.
    Full-text · Article · Jan 2014 · Journal of Nursing Management
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