Intention to leave among staff nurses in small- and medium-sized hospitals

Aims and objectivesTo explore the factors associated with the intention to leave among nurses in small- and medium-sized hospitals and to determine the predictors about work environment and rewards. BackgroundCompared with large hospitals, insight into the working conditions, rewards and turnover of nurses working for these hospitals is lacking internationally. DesignCross-sectional study design. MethodsData were obtained from the Korean Nurses Association's 2016 Welfare Policy and System Improvement Survey. Of the participants, data from 951 staff nurses working three shifts were analysed using hierarchical multiple regression to explore the predictors of nurses' turnover intention. This study complied with the Strengthening the Reporting of Observational studies in Epidemiology. ResultsThe perceived pay level satisfaction was the most obvious and persistent predictor of the intention to leave. Living benefits were shown to be scarcely satisfied, rendering considerable influence on turnover intention. Concerning aspects related to the working environment, the implementation of contract-abiding working hours and nurse-friendly night shift schedules reduced the turnover intention of nurses. ConclusionsNurses in small- and medium-sized hospitals are likely to have particular challenges in terms of professional growth. When fundamental rewards and basic working conditions are acceptable to nurses, their turnover can be reduced, and the professional growth can also be expected. Hospitals with a high nurse turnover rate need to preferentially verify these factors perceived by their nurses and to improve to increase nurses' retention. Relevance to clinical practiceUnderstanding the determinants of intention to leave can lead to the development of strategies that persuade nurses to remain employed. These findings inform policymakers, nurse managers and hospital managers of the causes of nurses' intentions to leave in small- and medium-sized hospitals. Our findings also provide empirical data on the working conditions and rewards of these nurses and suggest strategies for their retention.