Search

The bullying of nurses by patients, doctors, and employees is common in the healthcare industry. Nurses who are bullied are more likely to experience burnout, and nurses who experience burnout are more likely to intend to quit. However, few studies investigate how leadership can mitigate workplace incivility and nurse bullying as a way to improve nurse retention. A cross‐sectional study was conducted using a sample of 216 nurses recruited from various regions across the United States from different specialties. A moderated mediation model using path analysis was used to examine the relationships between bullying, burnout, and ethical leadership in predicting intentions to stay. Bullying significantly and positively related to burnout (β = 0.22, p = 0.02), and burnout significantly and negatively related to intent to stay (β = −0.18,p = 0.01). Perceived ethical leadership predicted intentions to stay (β = 0.62, p = 0.00), and ethical leadership moderated the effect of bullying on burnout (β = 0.20, p = 0.03). The results of our study also suggest that nurses are less likely to quit when ethical leadership is present, and ethical leadership weakens the effect of bullying on burnout. [ABSTRACT FROM AUTHOR]

Introduction. The COVID-19 pandemic has had a significant impact on healthcare professionals globally, with nurses facing diverse challenges at the forefront. Despite their resilience, nurses are experiencing emotional burdens, which have contributed to a growing intention to abandon the profession. Understanding these factors is crucial for addressing the global nursing shortage. Methods. A qualitative descriptive approach was utilized for this study. Nurses who were actively working during the last waves of the pandemic in Catalonia, Spain, were intentionally recruited through social media and personal contacts, and data were collected through online semistructured interviews until data saturation was reached. Data were analyzed using Braun and Clarke's thematic analysis method. Results. Fourteen nurses, with an average of 22.8 years of work experience, were interviewed. Thematic analysis revealed three main themes: (1) the impact of COVID-19 on health, (2) factors influencing the decision to stay, and (3) recommendations to improve crisis management. Conclusion. Nurses faced significant emotional impacts but demonstrated dedication and resilience. Their decision to persevere was influenced by factors such as responsibility, guilt, and economic stability. Urgent measures are necessary to provide tailored mental health support and recognize emotional challenges in crisis preparedness. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exacerbated the difficulties nurses face, resulting in higher turnover rates and workforce shortages. This study investigated the relationships between nurses' moral distress, burnout, and turnover intention during the last stage of the COVID-19 pandemic. It also explored the coping strategies nurses use to mitigate moral distress. Utilizing a mixed-method approach, this study analyzed data from 307 nurses caring for patients with COVID-19 in acute care hospitals through an online survey conducted in November 2022. Our data analysis encompassed quantitative methods, including descriptive statistics and path analysis, using a generalized structural equation model. For the qualitative aspect, we examined open-ended responses from 246 nurses using inductive content analysis. The quantitative findings revealed that nurses' moral distress had a significant direct effect on turnover intention. In addition, burnout significantly mediated the relationship between moral distress and turnover intention. Qualitative analyses contextualized the relationships uncovered in the quantitative analyses. The qualitative analysis identified various positive and negative coping strategies. Positive strategies included a commitment to minimize COVID-19 transmission risks, adopting a holistic approach amidst the challenges posed by the pandemic, voicing concerns for patient safety, engaging in continuous learning, and prioritizing self-care. Conversely, negative strategies involved adopting avoidance behaviors stemming from feelings of powerlessness and adopting a passive approach to one's role. Notably, some participants shifted from positive to negative coping strategies because of institutional barriers and challenges. The findings underscore the importance for hospital administrators and nurse managers to acknowledge the impact of the pandemic-related challenges encountered by nurses and recognize the link among moral distress, burnout, and turnover intention. It highlights the essential role of organizational and managerial support in fostering effective coping strategies among nurses to address moral distress. [ABSTRACT FROM AUTHOR]

Background. During a public health crisis, such as the COVID-19 pandemic, nurse leaders coordinate timely high-quality care, maintain profit margins, and ensure regulatory compliance while supporting the health and wellbeing of the nursing workforce. In a rapidly changing environment where resources may be scarce, nurse leaders are vulnerable to moral injury; however, organizational effectiveness may help to buffer moral challenges in healthcare leadership, thereby fostering greater moral resilience and reducing turnover intention. Aim. To understand mechanisms by which perceived organizational effectiveness contributes to nurse leaders' moral wellness (i.e., moral injury and moral resilience) and thereby effects work outcomes (i.e., engagement, burnout, and turnover intention). Methods. A cross-sectional survey of nurse leaders (N = 817) from across the United States was conducted using a snowball methodology, independent t-tests, and structural equation modeling to examine theoretical relationships among moral injury, moral resilience, and organizational effectiveness. Results. Higher ratings on every facet of perceived organizational effectiveness were significantly related to greater moral resilience (p < 0.001 for all t-tests) and lower moral injury (p < 0.001 for all t-tests) among nurse leaders. Structural equation models indicated both moral resilience and moral injury were significant mediators of the relationship between organizational effectiveness and work outcomes. Moral resilience and moral injury significantly mediated the effect of organizational effectiveness on burnout. Moral resilience was also a significant mediator of the relationship between organizational effectiveness and moral injury. Conclusion. Dismantling organizational patterns and processes in healthcare organizations that contribute to moral injury and lower moral resilience may be important levers for increasing engagement, decreasing burnout, and reducing turnover of nurse leaders. [ABSTRACT FROM AUTHOR]

Background. In addition to the usual difficulty of managing human capital in any organization, healthcare institutions have other problems to solve arising from the circumstances and the very nature of the work they perform, such as the ethical pressure on staff, emotional exhaustion, the distribution of work shifts, or the general shortage for nurses. In many cases, this situation has an impact on the quality of care. Objective. The main objective of this research is to compile, in a single document, human resource practices that help health centre managers improve results in terms of performance and quality of care, as well as avoid the intention of abandoning the job, specifically related to the work of nurses. Methods. To this end, a systematic literature review has been performed based on 229 papers published in the Web of Science database, from which the practical implications for nurses proposed by these authors have been extracted. Results. The main results suggest that developing affective commitment helps to improve organizational performance and enhance patient safety culture. Furthermore, improving communication and meaningfulness of work, recognition by superiors, or job flexibility would improve the quality of outcomes, for the work of nurses. Conclusions and Implications for Nursing. Stimulating normative commitment, reducing excessive control, and paying attention to job burnout and job stress help combat the intention of voluntary turnover or leaving the job, especially in the case of nurses. [ABSTRACT FROM AUTHOR]

Background. Haematology nurses in Singapore experience a highly stressful work environment and increased workload due to the growing number of patients and complex treatment regimens. High job demands can lead to burnout and high staff turnover rates, which compromises the quality of patient care. Aims. To assess perceived work demands, levels of social support from colleagues, professional quality of life (ProQOL), and turnover intentions among haematology nurses and examine whether demographic and occupational characteristics, perceived job demands, and support were associated with ProQOL and turnover intentions. Design. A descriptive, correlational, and cross-sectional design was used in this study. Methods. A convenience sample of 60 haematology nurses working at a tertiary hospital in Singapore completed a self-administered survey. Perceived job demands, support from colleagues, ProQOL, and turnover intentions were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ III), Professional Quality of Life Scale version 5 (ProQOL5), and Turnover Intention Scale (TIS-6). Descriptive statistics, chi-square test, and multiple linear regressions were employed for data analysis. Results. Haematology nurses face high cognitive and emotional demands and receive high levels of support from colleagues at work. The majority of the participants reported moderate to high levels of compassion satisfaction (78.3%), burnout (76.7%), and secondary traumatic stress (81.7%). 53.3% of the participants expressed their intention to leave. Perceived job demands were significant predictors of haematology nurses' ProQOL and turnover intentions. Compassion fatigue also significantly predicts turnover intentions. Conclusion. The high levels of burnout and secondary traumatic stress reported by haematology nurses highlight an urgent need to implement strategies to help nurses cope with the high work demands and reduce their levels of compassion fatigue. Implications for Nursing Management. The findings in this study can help nursing leaders understand haematology nurses' perceived job demands and ProQOL, to develop strategies to improve the workplace environment and retention. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Aims. We aimed to investigate nursing students' spiritual care competence, perceived professional benefit, and retention intention and to analyze the relationship among these variables. Background. Nurse shortages are a global issue, and intern nursing students' willingness to remain in the nursing profession is important. Spiritual care can reduce patients' depression and improve their quality of life. Implementing spiritual care can help individuals have satisfying experiences. Perceived professional benefit is a positive emotional experience that is important in retention intention. However, the relationship among spiritual care competence, perceived professional benefit, and retention intention remains unclear. Methods. In this cross-sectional and correlational study, convenience sampling was used to recruit 266 intern nursing students in 10 hospitals throughout China. An online questionnaire was used to assess their sociodemographic characteristics, spiritual care competence, perceived professional benefit, and retention intention. Statistical analyses included the t-test, analysis of variance, Pearson's correlation analysis, and bootstrap analysis. Results. Intern nursing students' mean scores were 103.35 ± 19.00 for spiritual care competence, 72.88 ± 10.40 for perceived professional benefit, and 19.58 ± 3.37 for retention intention. Spiritual care competence was positively correlated with perceived professional benefit (r = 0.545; p < 0.01) and retention intention (r = 0.149; p < 0.05). Perceived professional benefit was also positively correlated with retention intention (r = 0.320; p < 0.01). Bootstrap analysis showed that perceived professional benefit completely mediates the relationship between spiritual care competence and retention intention. Conclusions. We found that nursing interns had a moderate level of retention intention, and perceived professional benefit was the mediating variable between spiritual care competence and retention intention. Implications. Our study results suggest that nursing administrators and educators should improve nursing interns' spiritual care competence and perceived professional benefit to enhance their willingness to remain in the nursing profession and alleviate nurse shortages. [ABSTRACT FROM AUTHOR]

Background. Missed nursing care, which has been explored in various acute care settings, results in adverse patient outcomes and job dissatisfaction in nurses. However, little is known about missed care in the operating room. Objective. This study tested a hypothesised model to identify relationships between nurses' age, years of experience in the operating room, job satisfaction, and intention to leave which have direct and indirect effects on the frequency of missed care. The frequency of missed care was hypothesised to be mediated by nurses reported perioperative competence and the reasons for missed care. Design. A cross-sectional design using an online survey of Australian perioperative nurses was undertaken in 2022. Methods. All Australian College of Perioperative Nurses members were invited to participate. Missed nursing care was measured using the MISSCARE Survey-OR. Age, years of experience, and intention to leave were single-item measures. Satisfaction was a three-item scale. Competence was measured by the 18-item Perceived Perioperative Competence Scale-Short Form. Structural equation modelling was used to test our hypothesised model. Results. Of the 5,500 nurses invited, 853 (15.5%) responded, but only 602 (10.9%) participant responses were usable for inclusion in the model. The model demonstrates that participants' age directly predicted the frequency of missed care, nurse role satisfaction, perceived perioperative competence, and reasons for missed care. The reasons for missed care and perceived perioperative competence were mediators that were negatively associated with the frequency of missed care. Conclusions. While the final model explained 22.6% of the frequency of missed care, other variables not identified in this study may influence this outcome. [ABSTRACT FROM AUTHOR]

Aims. To examine the association between job satisfaction and the intention to leave and explore the factors associated with job satisfaction or the intention to leave among foreign-educated nurses in Japan. Design. A cross-sectional design was used, and data were collected through an online survey of nurses who were born and received their basic nursing education outside of Japan but are currently working as registered nurses in Japan. Data were analyzed across two phases: the first explored the related factors with intention to leave and job satisfaction using bivariate analysis and regression through IBM SPSS; the second examined the theoretical framework model using a structural equation model through IBM Amos. Results. Data from 180 participants (effective response rate: 87.4%) were analyzed. Overall, foreign-educated nurses reported moderate job satisfaction level in Japan. The final model showed good fit indices, indicating that higher workplace discrimination, lower Japanese language satisfaction, and not receiving orientation were predictors of foreign-educated nurses' lower job satisfaction. Lower job satisfaction, fewer years of nursing practice in Japan, single status, and higher language satisfaction predicted a higher intention to leave. Conclusion. This study provides incremental evidence of a negative relationship between job satisfaction and intention to leave among foreign-educated nurses in Japan. Workplace discrimination was the main predictor of nurses' job dissatisfaction and indirectly correlated with their intention to leave, as mediated by job satisfaction. Implications. Our study suggests that managers should provide a supportive and equal work environment, including implementing policies to reduce workplace discrimination and providing adequate support programs to enhance foreign-educated nurses' job satisfaction and reduce their turnover intention. [ABSTRACT FROM AUTHOR]

The retention and recruitment of care providers are ongoing concerns in healthcare globally. Examining intention to leave (ITL) as a measure of retention, the existing literature has focused on nurses working in hospitals, with less attention paid to other care providers and other areas of practice. The purpose of this study was to gain a better understanding of the unique factors influencing ITL among three categories of care providers in home care: registered practical nurses, registered nurses, and personal support workers. This study assessed and compared predictors of ITL, including organizational commitment, job satisfaction, perceived supervisor support, burnout, role stress, work/family conflict, and community satisfaction. A convenience sample of home care staff working in one agency in a Canadian province was sent an electronic survey by e-mail in 2021. Responses (n = 185) underwent data analysis including descriptive statistics, analysis of variance, and multiple linear regression, as well as thematic analysis of two open-ended items. The results of the study indicated that 54% (n = 99) of respondents were considering leaving their job, and respondents were dissatisfied with their salary and benefits. Role stress, work-family conflict, and burnout differed significantly between groups. Several themes emerged for strategies to promote employees to stay with the agency, with the overwhelming strategy being higher wages/salary. Themes for why employees stayed with the agency included love for clients and commitment to their care, as well as fondness for the teams within which respondents worked. The findings of the study lead to several important implications and recommendations for the home care sector. Advocating for wage parity among healthcare sectors and other opportunities for compensation for home care workers is necessary. Additional strategies include supportive and innovative approaches for scheduling, teamwork, and working with staff to identify barriers and solutions in home care. [ABSTRACT FROM AUTHOR]

Purpose. We investigate the associations between incivility from multiple sources (i.e., doctors, supervisors, fellow nurses, and patients/visitors) and nurse turnover intentions. We take a self-determination perspective to explore whether psychological needs for autonomy, belongingness, and competence explain the relationship between incivility and turnover intentions. Finally, we examine whether incivility from doctors, supervisors, fellow nurses, and patients/visitors may primarily relate to one of the three basic psychological needs and whether the autonomy need may have the strongest relationship with turnover intentions. Design. A three-wave time-lagged design was used. Each measurement point was separated by one workweek. New Zealand nurses were asked to evaluate their workplace incivility at Time 1, three basic psychological needs at Time 2, and turnover intentions at Time 3. Findings. Supervisor incivility directly related to turnover intentions. The autonomy need was the only significant mechanism underlying the relationships of incivility from doctors, supervisors, and fellow nurses with turnover intentions. In addition, doctor incivility related to the autonomy need, patient/visitor incivility was not significantly related to any psychological needs, and incivility from fellow nurses and supervisors related to psychological needs for belongingness and autonomy. Originality. This study takes a multifoci perspective to examine nurse incivility from multiple sources. The novelty lies in the introduction of self-determination theory to the understanding of workplace incivility. Finally, we turn the spotlight on the importance of examining whether incivility from different sources may be primarily related to different psychological needs and whether the autonomy need plays a key role in turnover intentions. [ABSTRACT FROM AUTHOR]

Aims. To identify the factors influencing critical care nurses' intention of physical restraint in intubated patients. Background. Physical restraint reduction has been advocated by many international institutions, nurses are the main physical restraint decision-makers, and it is critical to identify the factors influencing physical restraint intention from nurses' perspective. Methods. A cross-sectional study was conducted among critical care nurses in China from February 2022 to March 2022. Results. The model showed a good model fit (χ2/df = 2.57, RMSEA = 0.07, GFI = 0.94, CFI = 0.89, and AGFI = 0.90). Attitude (β = 0.29, p < 0.05), subjective norm (β = 0.25, p < 0.05), and perceived behavioral control (β = 0.32, p < 0.001) directly influenced the intention to use physical restraint in intubated patients. Ethical conflict (β = 0.04, p < 0.05) indirectly influenced the intention. Conclusions. The study revealed that ethical conflict, attitude, subjective norm, and perceived behavioral control were positive predictors of physical restraint intention among intubated patients from nurses' perspectives. Implications for Nursing Management. This provides a theoretical perspective to develop effective interventions to reduce physical restraints in critical care settings. Nursing managers should enhance ethical education and physical restraint knowledge and skill training. [ABSTRACT FROM AUTHOR]

Aim. The study is aimed at exploring the relationship between newly graduated nurses' transition shock, negative coping, job satisfaction, and intent to stay during the time of COVID-19. Background. The shortage of nurses is a global dilemma aggravated by the COVID-19 pandemic. It has been a hot topic in recent years to help newly graduated nurses transition smoothly. Transition shock is one of the essential indicators to describe the transition state of newly graduated nurses, which has a far-reaching impact on the intention of newly graduated nurses to stay in their posts. However, few studies have studied the mechanism behind this relationship, which may affect the effectiveness of retention strategies. Methods. A descriptive cross-sectional study was conducted from July to August 2021 in 31 tertiary hospitals in Shanghai, China. Participants comprised a convenience sample of 759 newly graduated nurses for surveys. Structural equation models were used to examine the study's hypothetical model. Results. The results showed that transition shock had a significant direct effect on job satisfaction (b = −0.412, p < 0.001) and intent to stay (b = −0.145, p < 0.001). Job satisfaction had a significant direct effect on intent to stay (b = 0.702, p < 0.001). The indirect effect of transition shock on intent to stay through job satisfaction was statistically significant (b = −0.289), the 95% C.I. was (−0.493, −0.357), and the proportion of mediating effect to total effect was 66.59%. Moreover, the moderated mediation analysis showed that the interaction effect of transition shock and negative coping style on job satisfaction was significant (b = −0.082, p < 0.001). Conclusion. This study revealed the impact of transition shock on intent to stay of newly graduated nurses during the time of COVID-19, and found that job satisfaction played a mediating role and negative coping played a moderating role. These findings are of great significance for nursing managers to take measures to improve the intention of newly graduated nurses to stay. Implication for Nursing Management. The level of transition shock is an important indicator reflecting the transition state of newly graduated nurses, and can further predict the job satisfaction and intention of newly graduated nurses to stay. Therefore, nursing managers should pay attention to taking corresponding measures to reduce the level of transition shock of newly graduated nurses. [ABSTRACT FROM AUTHOR]

Aim(s): The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care. Background: Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions. Method(s): A non‐experimental, cross‐sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included. Results: Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care. Conclusion(s): Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments. Implications for Nursing Management: Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the influence of a talent management scheme in an English National Health Service (NHS) Trust on registered nurses' retention intentions. Background: The retention of nurses is a global challenge, and talent management initiatives can play a role in improving retention. Talent management in its broadest sense is a way in which an organization recruits and retains the workforce that it needs to optimize the services it delivers. Methods: In this qualitative study, eight in‐depth semi‐structured interviews were conducted with registered nurses who had participated in a talent management initiative, at an English acute NHS Trust. Data were collected in July 2019. Results: The talent management initiative influenced positive retention intentions. Retention of nurses was facilitated by the creation of networks and networking. Conclusion: Networks and networking can be viewed as a form of social capital, which was a facilitating factor for positive retention intentions for nurses. Implications for Nursing Management: Talent management initiatives for nurses should be developed and directed to include the building of networks and networking to enable development of social capital. Although this talent management scheme is within the NHS, the issue of nursing retention is global. Application of learning from this paper to other health care systems is possible. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses. Background: Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large‐scale study has been conducted on these associations in China yet. Method: A cross‐sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported. Results: Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse–patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on‐the‐job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect. Conclusions: Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China. Implications for Nursing Management: Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress. [ABSTRACT FROM AUTHOR]

Aims: The aims of this work are to (1) investigate the work environment, resilience, burnout, and turnover intention and (2) examine how work environment and personal resilience impact burnout and turnover intention among nurse leaders in the midst of the COVID‐19 crisis. Background: The COVID‐19 pandemic introduced tremendous stressors to nurse leaders, for example, managing the complex staffing situation while balancing patients' and family's needs. Methods: During May to September 2021, an electronic survey was sent out to nurse leaders in Birmingham, Alabama, USA, and surrounding areas. Results: Fifty‐six respondents were included in the study. The composite score of the work environment measure was moderately to highly related to resilience [ρ (rho) =.59] and burnout [ρ = −.63 to −.68] but had small association to intent to leave [ρ = −.30]. The resilience was highly correlated to burnout [ρ = −.53 to −.59] and moderately associated to intent to leave [ρ = −.32]. Conclusions: A better work environment for nurse leaders is related to higher resilience, lower burnout, and lower turnover intention. Resilience impacts burnout and turnover intention among nurse leaders. Implications for Nursing Management: Health care organizations and stakeholders should implement effective strategies to improve the work environment, which could lead to enhanced resilience, reduced burnout, and lower turnover intention of their nurse leaders especially during and following this pandemic. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations. Background: Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown. Methods: This study used a two‐wave follow‐up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves. Results: EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure. Conclusion: Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces. Implications for Nursing Management: Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate health care professionals' perceived organizational support and its effect on their compassion, resilience and turnover intention in the United Arab Emirates. Background: The COVID‐19 pandemic exerted unprecedented pressure on health care systems, professionals and management systems. Health care organizations begin to explore their roles and function in relation to risks and resilience, in addition to ascertain what level of organization support they are providing to their workers. Methods: A cross‐sectional study was conducted with a questionnaire administered to 538 health care workers, to examine their personal resources and organizational support during the pandemic. Results: A total of 37.7% of nurses were found to have a moderate level of resilience, logistic regression showed that being married is a protective factor against resigning from the profession (OR = 0.462, P =.012, 95% CI: 0.254–0.842), and health care workers who perceived higher organizational support were approximately 50% less likely to have a turnover intention (OR = 0.506, P =.009, 95% CI: 0.303–0.845). Multiple linear regression model indicated significantly higher resilience among physicians (β = 0.12, P <.05) and allied health care practitioners (β = 0.12, P =.022). Organizational support had a significant positive relationship with resilience scores (β = 0.20, P <.001); adequate training was significantly related to higher compassion levels (β = 0.11, P <.05) and high organizational support scores were associated with increased compassion scores (β = 0.27, P <.001). Conclusions: Front‐line health care workers reported moderate organizational support during the pandemic, commensurately reflected in moderate levels of personal resilience and self‐compassion. Continued and better support is vital for employee sustainability and the increased health system performance, including quality of care and patient outcomes. Implications for nursing management: Nurse managers should help health care workers improve self‐care strategies by strengthening personal resources, including shortened duty hours, offering adequate break time, providing a safe work climate and purveying adequate personal protective equipment and supplies to combat infections. They should build an empathetic work environment through understanding the needs of staff, helping tackle their work stress and sustaining cultures of compassion through promoting rewarding and flexibility strategies. Moreover, policymakers and nurse mangers should create a rewarding culture for nurses and other health care workers to increase their commitment to their jobs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to identify factors that impact on early career nurses' intentions to remain in their current position and compare with what impacts on intention to remain in the profession. Background: Early exits of nurses from a position and the profession are a result of evolving factors. A lack of longitudinal follow‐up impedes knowledge about these factors or what proportion of temporary exits become permanent. Method: The study used prospective cohort survey design. The sample was obtained from non‐probability convenience sampling of graduating nursing students from two universities. Data was collected across three time points over 12 months, commencing in November 2016. Results: The professional turnover rate was 6.7% in total. Higher Work Environment, Support and Encouragement scores and Stress in personal life were the only predictors of intending to remain in the profession. Statistical modelling could not predict intention to remain in current position. Conclusion: There were differences identified when comparing intention to remain in a position and the profession. Nurses are satisfied with their career choice and intend to remain in the profession, although many are intending to move positions. Implications for Nursing Management: To effectively retain the nursing workforce, stakeholders must focus on the work environment, appropriate support and remuneration, and facilitate career progression. [ABSTRACT FROM AUTHOR]

Aim: The three‐component model of commitment, resilience and selected nurse characteristics were tested as predictors of nurses' intent to leave the profession. Background: In the wake of the COVID‐19 pandemic, news reports suggest that a mass exodus of nursing professionals is occurring. Method: This nonexperimental, descriptive, correlational, predictive study used a cross‐sectional approach to collect survey data from a convenience sample of 189 registered nurses (RNs) who were providing direct patient care in adult inpatient units with a high likelihood of admitting patients diagnosed with COVID‐19 and met other eligibility requirements. Results: Most (73.5%) plan to remain in the nursing profession and feel highly resilient. Only affective commitment demonstrated a significant relationship to the intention to leave the nursing profession. Conclusions: The study was conducted after the pandemic had been in effect for a prolonged time, and it is likely the nurses with the intent to leave the profession had already left. The findings provide a glimpse of a sample of nurses drawn from a population likely much different from only a few months prior. Implications for Nursing Management: Strategies to retain nurses should include efforts to strengthen professional commitment and build resilience. [ABSTRACT FROM AUTHOR]

Aim: To describe changes in distress among Danish hospital‐based nurses during the early month of the COVID‐19 pandemic and to examine predictors of distress and turnover intentions. Background: Outbreak of infectious diseases such as the COVID‐19 pandemic can increase the likelihood that health professionals suffer from poor mental health even after the outbreak. Methods: A prospective study among 426 Danish hospital‐based nurses during the early month of the pandemic. Participants completed self‐administered questionnaires regarding mental health and COVID‐19 worries, as well as turnover intentions. Results: Nurses with brief work experience reported higher increase in distress. Feeling unsafe at work, having low trust in management and being anxious for relatives were associated with increased distress. Finally, feeling unsafe at work, being anxious for relatives and having low trust in management were predictors of intention to change job. Conclusion: This study suggests that the subjective experiences of uncertainty in work during the COVID‐19 pandemic have more impact on nurses' distress than COVID‐19 related conditions at hospitals. Finally, the study provides empirical support for the association between COVID‐19‐related worries and turnover intentions. Implication for nursing management: Knowledge of risk factors for psychological distress as well as predictors of turnover intention is necessary and may provide nurses and health‐care systems with the ability to respond better against future pandemics and to retain nurses in the organization and in the profession. [ABSTRACT FROM AUTHOR]

Aims: This study examined how the mediating effect of psychological distress and the moderating role of social support influence the connection between psychological capital and turnover intention among Chinese nurses. Background: Nurses play a crucial role in medical and health services, but turnover intentions are common among them. Methods: A cross‐sectional survey was conducted involving 4865 nurses in China. The Chinese Psychological Capital Questionnaire, Depression, Anxiety and Stress Scale, Social Support Rating Scale, and Turnover Intention Scale were used to gather data. Bootstrap and simple slope methods were used to test the mediating effect of psychological distress and the moderating effect of social support. Results: Psychological capital had a significant direct impact on turnover intention among nurses (B = −0.040, t = −10.032, p <.001). Psychological distress had a mediation effect of 46.89% between psychological capital and turnover intention. Moreover, social support had a moderating role in the relationship between psychological distress and psychological capital and between psychological distress and turnover intention. Conclusions: Psychological capital correlated negatively with psychological distress and turnover intention and indirectly influenced turnover intention through psychological distress. Social support moderated the first and second half of the path in the mediating model of psychological distress. These findings have implications for early intervention for and the prevention of turnover intention in nurses. Implications for Nursing Management: This study's findings can inform the design of effective nurse support programmes to reduce the impact of psychological distress on turnover intention among nurses. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to examine the relationship between psychological ownership of the nursing profession and turnover intention. Background: There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated. Methods: This study adopted a cross‐sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical centre in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self‐Efficacy Scale and developed Having a Place Scale. Results: Psychological ownership comprises three dimensions: self‐efficacy, nurse identity and 'having a place' in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self‐efficacy and 'having a place' are negatively related to nurses' intention to leave a hospital (r = −.23 and −.31, p <.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r = −.38, p <.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r =.76, p <.001). Conclusion: The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management: Nurse managers can enhance nurses' self‐efficacy and sense of 'having a place' to retain nurses in hospitals, while enhancing nurse identity to retain nurses in the profession. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of job embeddedness and nursing working environment on trauma centre nurses' turnover intention. Background: Trauma centre nurses have higher average turnover intention than hospital nurses. However, factors that increase the turnover intention of trauma centre nurses remain unexplored. Methods: This cross‐sectional study was conducted from August to October 2019, with 120 trauma centre nurses working at three trauma centres in B, D and U cities using measures of demographic characteristics, job embeddedness, nursing working environment and turnover intention. Results: The mean turnover intention score was 3.60/5 points. There were significant correlations among turnover intention and fit, sacrifice, foundation for quality nursing, ability and leadership of nursing managers, cooperation of nurses and doctors, nurse participation in hospital management and sufficient manpower and material support. Turnover intention was predicted by nurse participation in hospital management, gender, clinical experience and fit, which explained 54%. Conclusions: Factors that influence nurses' turnover intention at trauma centres were gender, clinical experience, job fit and, especially, nurses' participation in hospital management, which had the most effect on the nursing working environment. Implications for Nursing Management: To expand participation of trauma centre nurses, hospital management systems and organisational culture need improvement. [ABSTRACT FROM AUTHOR]

Aim: To explore junior nurses' and final‐year student nurses' intention to care for COVID‐19 patients amidst the Delta COVID‐19 variant outbreak in China using the theory of planned behaviour (TPB) as a framework. Background: The COVID‐19 pandemic has intensified global nursing shortage. Junior nurses and final‐year student nurses represent the backbone of the future frontline nursing workforce. The TPB is a valid theoretical model for predicting nurses' caring behaviours. Methods: A 47‐item self‐administered questionnaire was disseminated online to a convenience sample of 547 junior nurses and final‐year student nurses located in 13 regions across mainland China. Results: Approximately 63.4% of the participants intended to care for COVID‐19 patients voluntarily and 65.6% by non‐voluntary assignment. The TPB model significantly predicted 45% of the variance in behavioural intention, subjective norms being the strongest predictor. Gender, vaccination status and ethical perceptions regarding frontline work significantly correlated with the intention to provide care. Conclusions: Our findings highlight the importance of social, organisational and family support underpinning future junior nurses' professional commitment in times of public health crisis. Implications for nursing management: Pandemic‐tailored workplace training programmes for nurses/student nurses that emphasize on self‐care and ethical issue discussions are warranted. Hospital managers should collaborate with community partners to offer additional family support for nurses in need. [ABSTRACT FROM AUTHOR]

Aim: To examine the impact that patient violence, experienced in the emergency department, has on emergency nurses' intention to leave their job. Background: Emergency departments have become known for their overcrowding, chaos, unpredictability and violence. Emergency nurses are at high risk of experiencing workplace violence, which is cited in the literature as having a direct effect on general nurses' intention to leave. A high rate of nursing turnover may lead to short staffing, jeopardize the quality of patient care and increase overcrowding and wait times. Evaluation: A systematic review was undertaken in CINAHL, Medline and Psych INFO databases using published data until November 2021. Six articles were included, and PRISMA guidelines were adhered it. Key Issues: Workplace violence in the emergency department had a direct impact on emergency nurses' intention to leave and decreased their job satisfaction. Verbal abuse is the most experienced form of workplace violence. Conclusions: Workplace violence experienced by emergency nurses in the emergency department had a direct positive impact on their intention to leave and subsequently negative impact on their job satisfaction. Implications for Nursing Management: This review may inform clinical decision‐making and aid in the development of clinical practice guidelines for a workplace violence prevention programme, specific to the emergency department. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to examine staffing, personal protective equipment (PPE) adequacy and physical exhaustion that contributed to burnout and intent to leave among hospital nurses during the first peak of the COVID‐19 pandemic. Background: Burnout is associated with adverse nurse and patient outcomes. Identifying the magnitude of burnout that occurred during the pandemic can prepare managers for the long‐term mental health effects on nurses. Methods: A cross‐sectional, electronic survey was administered to examine perceptions of burnout and intent to leave among all New Jersey hospital nurses from October 6 to October 26, 2020. Results: A total of 3030 nurses responded with 64.3% reporting burnout and 36.5% reporting intent to leave the hospital within a year. There was a significant association between high levels of burnout and intent to leave (χ2 = 329.4; p =.001). There was no association between staffing and burnout; however, reporting inadequate PPE (OR = 1.77 [95% CI: 1.34–2.34]) and physical exhaustion (OR = 3.89 [95% CI: 3.19–4.76]) remained predictors of burnout among nurses. Conclusion: Inadequate PPE and physical exhaustion coupled with short staffing contributed to burnout and intent to leave. Implications for Nursing Management: Managers should continue to utilize evidence‐based mental health interventions and advocate within their nursing professional organizations for relief funds to reduce burnout. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to investigate the relationships between turnover intention and related constructs in an abusive supervision climate. Background: An abusive supervision climate is a work environment that is affected by the negative attitudes of an abusive supervisor. Method: The constructs are chosen in light of upper echelons theory and social learning theory. The snowball sampling method is used to reach the participants, and 230 nurses working in Turkish hospitals participated in this survey that measured abusive supervision, workplace incivility and ostracism. Pearson's correlation analysis and multiple and hierarchical linear regression analyses are carried out. Results: The results suggested that abusive supervision, workplace incivility and workplace bullying have a positive effect on turnover intention as hypothesized. Abusive supervision has a significant and positive effect on workplace incivility and workplace bullying. The partial mediating effects of workplace bullying, workplace incivility and workplace ostracism on the relationship between abusive supervision and turnover intention are also confirmed. Conclusion: The significant relationships and the nonsignificant relationship provided evidence for an abusive supervision climate. Implications for Nursing Management: Top managers of the health care facilities should attempt to determine the abusive supervisors to manage the work environment and turnover intention of nurses. [ABSTRACT FROM AUTHOR]

Aim: To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship. Background: Workplace violence has emerged as a crucial determinant of turnover intention for health care workers. Methods: A cross‐sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator. Results: Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention. Conclusions: Chinese health care workers experiencing violence during the COVID‐19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention. Implications for Nursing Management: Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post‐violence mental health problems. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the perceived empowerment and turnover intention of middle nurse managers before and after the implementation of a major reform of the health care system in Cyprus, which also includes the transition of public hospitals towards administrative and financial autonomy. Background: The empowerment of nurse managers is important since previous studies have shown that it is associated with performance at work and may have an impact on their turnover intention. Methods: A repeated cross‐sectional study was conducted in March 2019 (first phase) and was repeated in March 2020 (second phase), after the introduction of major changes. The target population was all nurse managers of the public hospitals. The final sample consisted of 175 (RR 94%) participants in the first phase and 178 (RR 95.6%) in the second. Results: Measurements at both time points revealed moderate levels of perceived empowerment among Cyprus nurse managers. Empowerment score (17.95) appeared slightly lower at the repeat measurement compared to the first empowerment score (18), but the observed difference was not statistically significant (p = 0.184). Among the categories of empowerment opportunities was presenting statistically significant differences between the two phases. At the second phase, mean scores of empowerment were consistently lower among those who stated YES compared to those who stated NO in relation to (a) the intention to change department, (b) the intention to change profession and (c) the intention to change organization/hospital. Conclusions: This study demonstrated lower levels of empowerment among nurse managers with turnover intentions. It is therefore needed to be investigated further whether lower empowerment levels are the main reason for turnover intentions. It also suggests the need for senior management to create opportunities and to develop and implement interventions which aim to maintain and further improve the empowerment of the nurse managers and assess their effectiveness in terms of turnover intention in the organization. Implications for nursing policy: The senior management of the hospitals needs to adopt retention strategies by establishing an empowered positive working environment for nurse managers. Nurse managers need to collaborate with the senior management and seek more access to opportunities, information, support and resources which will enable them to perform their duties with efficiency and be more effective. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the relationship between workplace incivility and the turnover intention in nurses. Background: Studies assessing the association between nurses' turnover intention and workplace incivility are limited. Methods: The research was carried out on a total of 250 nurses working in three private hospitals in Antalya, Turkey. The data were collected using a Demographic Questionnaire, the Workplace Incivility Scale and the Turnover Intention Scale. Results: The mean workplace incivility scores of the nurses were determined to be 6.68 ± 7.96. The mean turnover intention scores of the nurses were 6.38 ± 3.44. A statistically significant positive relationship was found between workplace incivility scores and turnover intention scores (r = 0.632, p = 0.0001). The linear regression model showed that workplace incivility, working in the emergency or intensive care unit, and dissatisfaction with the current institution were independent factors of turnover intention. Conclusions: The results of the study demonstrated a significant relationship between workplace incivility and turnover intention in nurses. Nurses who are less exposed to workplace incivility were seen to have a lower turnover intention. Implications for Nursing Management: Simple measures that organisations may take to reduce workplace incivility may increase nurses' workplace satisfaction, reduce turnover intention and enable them to work more efficiently. It would be useful for nursing managers to lead initiatives in institutions to reduce workplace incivility and improve the culture of civility. [ABSTRACT FROM AUTHOR]

Background: Turnover among frontline health care workers, particularly nurses, reached an alarming rate during the COVID‐19 pandemic. This turnover has been attributed, in part, to excessive fear of the virus (a condition called coronaphobia). Studies have not yet been conducted examining whether social support and coping skills could act as buffers between coronaphobia and the intention to leave. Aim: To examine the relationship between coronaphobia and frontline nurses' organisational and professional turnover intention and to assess whether social support and coping skills can buffer this relationship. Methods: A correlational research design was used to collect responses through an online questionnaire from a convenience sample of 687 frontline nurses from the Central Philippines. Data were analyzed using descriptive (mean, standard deviation and percentages) and inferential statistics (t test, Pearson r correlation coefficient, ANOVA and multiple linear regression). Results: More than half of the frontline nurses experienced coronaphobia, while 25.8% reported a desire to leave their job and 20.7% reported a desire to leave their profession. Coronaphobia had direct significant effects on nurses' organisational (β =.424, p <.001) and professional turnover intention (β =.316, p <.001). Social support and coping skills partially mediated the relationship between organisational (β =.365, p <.001; β =.362, p <.001) and professional turnover intention (β =.279, p <.001; β =.289, p <.001). Conclusion: Frontline nurses who experienced coronaphobia were more likely to quit their job and the nursing profession. Increasing nurses' social support and enhancing their coping skills reduced the negative effects of coronaphobia, resulting in improved nurse retention. Implications for Nursing Management: Institutional approaches to reduce coronaphobia and turnover intention during the pandemic can be facilitated by improving social support through innovative approaches (e.g., use of technology and social media) and equipping nurses with positive coping skills through coping skills training and other empirically based coping skill‐building interventions. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study is elaborating on the relationship between burnout and turnover intention. Background: Burnout and its dimensions have a significant effect on turnover intention. Evaluation: Meta‐analysis technique is used. Forty‐four studies were brought together to form four data sets. These data sets were heterogeneous, and they did not include publication bias. The effect sizes of burnout, emotional exhaustion, depersonalization and professional efficacy on turnover intention among nurses were computed. Key Issues: Random‐effects model was used. The groups including two or more studies were added into moderator analysis. Conclusions: The effect size of the relationship between professional efficacy and turnover intention was small, and the effect size of the other surveyed reationships was medium among both nurses and other health employees. The moderator analysis results suggested that the effect size of the relationship between professional efficacy and turnover intention among nurses is significantly different from the other health employees. Being a nurse was determined as a significant moderator for the relationship between professional inefficacy and turnover intention, and it weakened this relationship. Implications for Nursing Management: The findings of this study can be used by health managers as burnout and turnover intention are important to determine organizational policies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore primary health care nurses' mental health, concerns and perceived safety and supports during COVID‐19. Background: Respiratory pandemics have negative impacts on nurses' wellbeing. While literature is replete with hospital nurses' experiences, there is less exploration of COVID‐19 impacts on primary health care nurses. Given the importance of primary health care nurses in the health system, understanding their experiences is vital. Methods: Three hundred and fifty nine primary health care nurses responded to an online cross‐sectional survey. The Depression Anxiety Stress Scales (DASS‐21) was used to measure emotional state. Data were analysed using descriptive and inferential statistics. Results: DASS‐21 scores indicated that 39.6% of participants were experiencing symptoms of depression, anxiety or stress. Of those, 41.8% were experiencing symptoms on one scale, 26.9% were experiencing symptoms on two scales and 31.2% were experiencing symptoms across all three scales. Most participants identified that their feelings were related to COVID‐19. Conclusions: COVID‐19 is having a significant impact on primary health care nurses' mental health. Nurse managers need to develop strategies to effectively address nurses' concerns and effectively support them to sustain the workforce during and after the pandemic. Implications for Nursing Management: Findings from this study can inform the design of effective nurse support programmes to reduce mental health impacts and promote staff wellbeing during the pandemic. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe why registered nurses decide to leave their work and to investigate relationships between registered nurses' working life and turnover (leaving the unit vs. leaving the profession). Background: Much research has explored nurses' intention to leave, whereas less research has looked at turnover and especially leaving the profession. Methods: Data were collected using questionnaires and interviews. Results: The three most common reasons for both groups (leaving the profession, n = 40; leaving unit but not profession, n = 256) were high workload, low salary and applied for and got a new job. Multivariate logistic regression analysis revealed statistically significant relationships between turnover and empowering structures, such as access to resources and informal power as well as the factor learning in thriving. Conclusions: Structural empowerment, such as good access to resources and informal power, is important to keeping nurses in the profession, whereas learning seems to increase the risk of leaving the profession when variables such as vitality, resources, informal power and age are held constant. Implications for Nursing Management: To counteract nurses leaving the profession, managers must provide nurses with good access to resources and informal power, such as networks within and outside the organisation, and focus on nurses' vitality. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine, through the lens of the Job Demands‐Resources model, the influence of caring for COVID‐19 patients on nurse's perception of chronic fatigue, quality of care, satisfaction at work and intention to leave their organisation and the profession. Background: Studies have examined how fear of COVID‐19 contributes to the mental, physical and work adjustment among nurses. To date, few studies have been conducted examining how caring for patients with COVID‐19 contributes to work outcomes among nurses. Methods: This is a cross‐sectional survey involving 1705 frontline nurses and licensed practical nurses in Quebec, Canada. From these, 782 reported caring for COVID‐19 patients. Results: High chronic fatigue, poor quality of care, lower work satisfaction and higher intention to leave their organisation were found for nurses caring for COVID‐19 patients. Poorly prepared and overwhelmed nurses showed higher turnover intention than those well prepared and in control. Conclusions: There is an urgent need to provide support to nurses during the pandemic, with a long‐term strategy to increase their retention. Implications for Nursing Management: Nurse administrators play an important role in supporting their nurses during a pandemic in the form of education, training and policy development to positively impact quality of care and retention. [ABSTRACT FROM AUTHOR]

Aims: This study aims to assess the prevalence of stress‐related outcomes (burnout, sleep problems and post‐traumatic stress) and occupational well‐being (work engagement, job satisfaction and turnover intention) of Dutch emergency room nurses and to identify job factors related to key outcomes. Background: While emergency nurses are prone to stress‐related outcomes, no large‐scale studies have been conducted in the Netherlands. Furthermore, few studies considered combined effects of job factors on emergency nurses' well‐being. Methods: In 2017, an occupation‐specific survey was filled out by 701 (response: 74%) emergency nurses from 19 Dutch hospitals. Decision tree methods were used to identify the most important (combination of) job factors related to key outcomes. Results: High prevalence of stress‐related outcomes and turnover intention were found, while the majority experienced work engagement and were satisfied with their job. Emotional exhaustion was mainly associated with worktime demands and aggression/conflict situations. Work engagement was mainly associated with developmental opportunities. Conclusions: Dutch emergency room nurses are at risk of stress‐related outcomes and have high turnover intention, while feeling engaged and satisfied with their job. Implications for Nursing Management: To retain and attract emergency room nurses, it is recommended to focus efforts on increasing developmental opportunities, while reducing worktime demands and aggression incidents. [ABSTRACT FROM AUTHOR]

Aim: To investigate the influence of workplace spirituality and organizational justice on the turnover intentions of mental health professionals working in small‐sized communities. Background: Many community mental health facilities in Korea are consist of the small size of members, and the turnover rate of mental health professionals is high. However, the influence of individual and organizational factors for lowering the turnover is not clearly identified. Method: This was a descriptive study. Data of 168 participants were collected through a self‐reported online questionnaire using a convenience sample, June 2020. Result: Multiple regression analysis uses interactional justice (β = −.437, p =.002), distributional justice (β = −.190, p =.011) and age (β = −.152, p =.033) that were the most important predictors of turnover intention. Conclusion: Orgnisational factors such as distributional and interactional justice affect to reduce turnover intention more than an individual factor like the workplace spirituality of professionals. Implications for Nursing Management: Small‐sized mental health institutions in the community should establish a clear working guideline that can make the distribution, procedure and interactional justice. Because only a small percentage of nurses work at community mental health facilities, it is necessary to reduce turnover by creating a work environment where young nurse practitioners can work long‐term and grow into leaders. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to examine (a) public image of nursing and the intention to choose nursing as a future career and (b) the relationship between the public image, gender roles and the choice of the nursing career among Arab high school students. Background: School graduates from the Arab sector represent an important social group with the potential to provide quality candidates for the nursing profession in Israel. Methods: In this cross‐sectional study, 138 high school students from two Arab schools in Israel completed a structured questionnaire. Results: One third of the sample intended to choose nursing as a future career. Students from families with a higher level of paternal education and those exposed to the work of nurses perceived nursing as more positive. The profession's public image contributed to the explanation of 21% of the variance of the intention to choose a nursing career. Conclusion: A positive public image of nursing contributes to decisions about choosing a nursing career in the future among Arab high school students. Implications for Nursing Management: School graduates may be influenced by providing information and presenting the role of a nurse as significant, as well as by emphasizing the positive image of nursing to parents and influential people in the Arab community. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work was to examine the mediating role of transition shock on the relationships between resilience, social support, work environment, and turnover intention in newly graduated nurses. Background: Reports assessing the associations between nurses' resilience, social support, work environment, and turnover intention, both directly and through the mediating effect of transition shock, are scarce. Methods: This was a cross‐sectional study, which recruited 361 Chinese newly graduated nurses with <1 year of work experience. Results: Resilience, social support, and work environment directly and significantly predicted transition shock (direct effect −0.158 to −0.350, p <.01). Resilience, work environment, and transition shock directly and significantly affected turnover intention (direct effect −0.118 to −0.257, p <.05). Transition shock mediated the relationships between resilience, social support, work environment, and turnover intention indirectly and significantly (indirect effect −0.019 to −0.041, p <.05). Conclusions: The results suggest that nurse managers could enhance resilience and social support and establish a positive work environment to reduce transition shock and turnover intention. Implications for Nursing Management: Nurse managers could continuously provide resilience training and develop a supportive workplace climate for newly graduated nurses to facilitate smooth transition into clinical practice, could alleviate their transition shock and turnover intention. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors affecting nurses' turnover intention. Background: The shortage of nurses has been a great challenge worldwide, and nurses' turnover may exacerbate the situation. Methods: A cross‐sectional study was conducted among nurses in six secondary hospitals in China. A model was constructed, and structured questionnaires were adopted to measure model variables. Structural equation modelling was used to verify the model. Results: Totally, 594 valid questionnaires were collected. The final model showed an acceptable fit, and 35.0% of the total variation was explained. Nine of the ten pathways were statistically significant. The model verified the contribution of professional value, nursing practice, job stress and social support to turnover intention and their effects were mediated by job satisfaction and organisational commitment. As hypothesized, there existed a significant effect between job satisfaction and organisational commitment. Unexpectedly, job stress had a greater direct effect on turnover intention than job satisfaction and organisational commitment. Conclusions: The structural model provided a feasible model that could explain nurses' turnover intention in China. Implications for Nursing Management: To prevent the turnover of nurses, administrators and managers should advisably prioritize the effect of job stress, especially in hospitals with similar medical context. [ABSTRACT FROM AUTHOR]

Aim: To examine the factors affecting actual turnover among nurses working in hospitals using the Brewer–Kovner synthesis model. Background: To increase retention of nurses, it is important to understand factors contributing to actual turnover among nurses. Methods: A longitudinal study design was utilized with 2,633 of 20,613 eligible female hospital nurses who participated in Korea Nurses' Health Study. We created two age groups: a younger group (20–35 years) and an older group (36–49 years). Multivariate logistic regression was used to identify the factors influencing turnover by age group. Results: Pregnancy and childbirth increased young nurses' turnover. When we excluded intent to leave, depression and burnout were significant factors affecting young nurses' turnover. Salary and hospital size were factors predicting nurse turnover among nurses older than 36 years. Conclusions: It is essential to develop prevention strategies of female nurse turnover based on the age group in Korea. Implications for Nursing Management: Nurse managers and health care institutes need to develop new managerial and policy strategies to reduce nurse turnover in each age group. [ABSTRACT FROM AUTHOR]

Aim: This cross‐sectional study, conducted from August to September 2020, examined nurses' stress, self‐efficacy and nursing intentions when caring for COVID‐19 patients and identified the predictors of nursing intentions during the pandemic. Background: The COVID‐19 outbreak has increased nurses' role expectations and imposed a heavy social responsibility. In particular, frontline nurses are under significant stress when caring for patients during a novel epidemic because of the lack of accurate information. Methods: A total of 232 nurses with experience in providing care for suspected or confirmed COVID‐19 patients from seven large hospitals in three cities in Korea completed the Perceived Stress Scale, Self‐Efficacy Scale and Predictive Nursing Intention Scale. Results: Multiple regression confirmed that completing COVID‐19‐related education and self‐efficacy were significant predictors of nursing intentions during the current pandemic; the regression model explained 22.0% of the variance in nursing intentions. Conclusion: Stress did not affect frontline nurses' nursing intentions towards COVID‐19 patient care, but completing COVID‐19‐related education and higher self‐efficacy predicted improved nursing intentions. Implications for Nursing Management: Nurse leaders should recognize that to improve nursing intentions during a novel infection outbreak, infection‐related education should be provided and strategies to improve self‐efficacy should be implemented. [ABSTRACT FROM AUTHOR]

Aim: To investigate how distributed leadership via the Shared Governance programme influences employee engagement, empowerment, job satisfaction and turnover intentions among direct care nursing staff in a large UK hospital. Background: Increasing turnover rates and shortages of health care staff in the UK has called for interventions to improve employee engagement and job satisfaction. Methods: 116 direct care nursing staff were sampled in a mixed‐methods explanatory sequential design. A maximum variance sample of 15 participants were subsequently interviewed to gain a deeper understanding of the motivations and attitudes that influenced employee outcomes through distributed leadership. Results: Higher levels of distributed leadership predicted increased employee engagement and job satisfaction, and lower turnover intentions. Staff also felt more empowered and committed to the organisation despite some challenges experienced in implementing the Shared Governance programme. Conclusion: Distributed leadership was found to be beneficial in promoting employee engagement and empowerment, increasing job satisfaction and organisational commitment and reducing turnover intention in the UK health care setting. Implications for Nursing Management: By encouraging the practice of distributed leadership at work, health care staff can become more engaged and empowered, leading to higher rates of job retention, job satisfaction and organisational commitment. [ABSTRACT FROM AUTHOR]

Aim: To explore the current status of Chinese nurses' willingness to work during the COVID‐19 pandemic and the factors that influence them. Background: The demand for front‐line nurses continues to grow during the COVID‐19 pandemic, but their willingness varies significantly. Therefore, it is crucial to explore nurses' willingness to report for front‐line work. Methods: A cross‐sectional study of 1,310 nurses from six tertiary hospitals was conducted. The participants completed self‐administered online questionnaires. Results: A total of 90.5% of nurses reported that they would like to voluntarily participate in front‐line work. Those with previous training, higher self‐efficacy scores, and lower perceived risk and self‐worth scores were more likely to participate in front‐line work, while nurses, who had 11–15 years of work experience and were worried about their family and the lack of family support, were less likely to be involved in front‐line work. Conclusion: This study found that the vast majority of nurses were willing to participate in front‐line work and affirmed the positive effects of previous infection prevention training, self‐efficacy and self‐worth. Implications for Nursing Management: This research emphasizes the necessity of infection prevention training and provides evidence for further emergency workforce deployment and incentives. [ABSTRACT FROM AUTHOR]

Aim: To determine the factors affecting the professional and institutional satisfaction of new graduate nurses in their first year of work, their adaptation process and their intentions of leaving the nursing profession. Background: The number of new graduates has been increasing in the global labour force, yet a significant proportion of them have left their profession. The first year in the nursing profession is particularly stressful and challenging for new graduate nurses. Methods: The study was conducted at four hospitals with 428 new graduate nurses who were in the first years of their careers. Results: The nurses' mean score, out of ten, was 5.52 points for job satisfaction and 5.16 points for satisfaction with their institution. Of them, 47.7% had difficulties adapting to nursing, and 53.5% had issues adapting to their jobs. Of them, 42.5% had considered leaving nursing, and 50.9% planned to leave their institutions. Conclusions: New graduates that perceive high workload, poor communication with patients and families or team members or inadequate skills and knowledge are more likely to consider turnover or leaving the profession. Implication for Nursing Management: New graduates suggested that better cooperation and teamwork, participation in decisions, consideration of requests for placement in a specific department, fair distribution of duties and shifts and in‐unit professional development opportunities would all improve the work environment and decrease risk of turnover. [ABSTRACT FROM AUTHOR]

Aim: To measure nurses' turnover intention and identify associated factors in general hospitals in China. Background: Understanding nurses' turnover intention is important to retain nurses, but factors associated with turnover intention require elucidation. Method: A cross‐sectional survey was conducted across 23 hospitals in China to investigate nurses' (N = 12,291) turnover intention and its associated factors. Associated factors were explored by univariate and multilevel multiple logistic regression analysis. Results: The mean total score for nurses' turnover intention was 13.97 ± 3.63. High proactive personality score, a seriously ill family member, experience of negative workplace events, high work pressure and high work–family conflict increased the risk for turnover intention. A low turnover intention was associated with being a non‐local resident nurse, position title, high salary level, good person–organisation fit and person–group fit, and high family–work facilitation. Conclusion: Nurses with a proactive personality, heavy family care burden, experience of negative workplace events, no position title and a low salary may merit special consideration. Implications for Nursing Management: Nurses' personality traits should be further focused on, and it is important to build a nurse‐oriented organisation atmosphere, including protecting nurses from workplace violence, establishing friendly relationships with their families and expanding career paths. [ABSTRACT FROM AUTHOR]

Background: Reforming health care systems can influence the workers. Among the aspects that could be influenced are the perception of job security, job satisfaction and turnover intention. However, nurses' perception on job security, job satisfaction and turnover intention during health care reform and privatization is a topic yet to be explored. Objectives: To examine the link between job security, job satisfaction and turnover intention during the reform and privatization of a health care system. Design: A cross‐sectional survey design was utilized in this study. Methods: The survey was composed of sociodemographic items, global job satisfaction item, global turnover items and job security scale. Data were analysed using SPSS, and univariate, bivariate and multivariate analyses tests were used. Results: Although job satisfaction partially mediated the association between job security and organisational turnover during health care reform, it completely mediated the association between job security and professional turnover intention. Conclusions: Further research is needed to examine this finding. Implication for nursing management: The findings of this study benefit nurse managers and leaders for their evidence‐based management. Moreover, this study will help them focus on practices that satisfy the staff and improve the job security by improving the communication and work on changing the policy. [ABSTRACT FROM AUTHOR]