Nurse intention to remain employed: understanding and strengthening determinants

Aim: This paper reports a study testing a hypothesized model of the determinants of nurse intention to remain employed in current hospitals of employment. Background: Previous research has shown that stronger nurse intention to remain employed is associated with higher job satisfaction, higher organizational commitment, higher perceived manager support, lower burnout, higher work group cohesion, being older, having more years of nursing experience and having lower levels of education. Methods: A descriptive survey design was adopted. Over 13,000 Ontario, Canada nurses were invited to complete a mailed survey between February and May 2003. The Ontario Nurse Survey includes instruments and items measuring job satisfaction, burnout, professional nursing practice environment, demographic characteristics of nurse respondents and items about intention to remain employed. Two multiple regression models, one including all variables and the other using a stepwise method, were used to test the proposed model. Results: Regression models explained 34% of variance in nurse intention to remain employed. The strongest predictors were nurse age, overall nurse job satisfaction and years of employment in the current hospital. Although the proposed model hypothesized six categories of predictors of intention to remain employed, only four of these were statistically significant determinants of nurse intention to remain: job satisfaction, personal characteristics of nurses, work group cohesion and collaboration, and organizational commitment of nurses. The other two categories of predictors, nurse burnout and nurse manager ability and support, may be predictors of job satisfaction and have indirect effects on intention to remain employed that are mediated through job satisfaction. Conclusion: Possible strategies to strengthen predictors of intention to remain employed include employment practices that reflect moral integrity, incorporate clear communication systems, maximize employee involvement in decision-making, promote praise and recognition, and establish a shared vision and goals.