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It is vital for the healthcare system that nurses of children and young people have the ability and courage to lead. These qualities can affect all elements of healthcare, from direct care through service commissioning ( Royal College of Nursing 2014 ) to staff satisfaction and retention ( Kerfoot 2000 , Corning 2002 , Heller et al 2004 ).

Aim To investigate predictors of hospital nurses' intent to stay in the nursing profession. Methods A cross-sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate. Findings Regression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay. Conclusion Possible strategies to improve nurses' intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses' personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses' normative commitment and economic costs commitment. Increased effort should be made to improve nurses' conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing. Study limitations Participants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study.

Wang L, Tao H, Ellenbecker CH & Liu X (2012) Job satisfaction, occupational commitment and intent to stay among Chinese nurses: a cross-sectional questionnaire survey. Journal of Advanced Nursing68(3), 539–549. Abstract Aim. This study was designed to identify the level of nurses’ job satisfaction, occupational commitment and intent to stay among mainland Chinese nurses, to explore the relationship among them. Background. Little is known about the magnitude of Chinese nurses’ intent to stay. Understanding the association among demographic characteristics and job satisfaction, occupational commitment and intent to stay among Chinese nurses is most important in a time of nurse shortages. Methods. A descriptive correlation design was used to examine the relationship among variables related to intent to stay. Data were collected by a self-administered survey questionnaire from 560 nurses working in four large hospital facilities in Shanghai in 2009. Results. The mean scores for nurses’ job satisfaction, occupational commitment and intent to stay were 3·25(0·48), 3·11(0·40) and 3·56(0·65), respectively. Job satisfaction and occupational commitment were significantly related to intent to stay. A statistically significant positive correlation was found between occupational commitment and job satisfaction. Age and job position were significantly related to job satisfaction, occupational commitment and intent to stay. Conclusion. Levels of job satisfaction, occupational commitment and intent to stay reported by nurses in this study can be improved. Suggested strategies for improvement are: increasing salaries, decreasing workloads, modifying task structure, cultivating work passion and creating more professional opportunity for nurses’ personal growth development and promotion. Enhancing nurses’ job satisfaction and occupational commitment are vital to improve nurses’ intent to stay and for strategies to address the nursing shortage.

Aims. This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. Background. Numerous scales have been developed to measure nurses’ job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. Methods. A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's α internal consistency reliability coefficients. The data were collected in 2003. Results. Nine factors contributing to home healthcare nurses’ job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0·4. Cronbach's α coefficients for each of the nine subscales ranged from 0·64 to 0·83; the α for the global scale was 0·89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0·79, indicating good criterion-related validity. Conclusions. The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.

Background. Predicted severe nursing shortages and an increasing demand for home health care services have made the retention of experienced, qualified nursing staff a priority for health care organizations. Aims. The purpose of this paper is to describe a theoretical model of job retention for home health care nurses. Methods. The theoretical model is an integration of the findings of empirical research related to intent to stay and retention, components of Neal's theory of home health care nursing practice and findings from earlier work to develop an instrument to measure home health care nurses’ job satisfaction. Discussion. The theoretical model identifies antecedents to job satisfaction of home health care nurses. The antecedents are intrinsic and extrinsic job characteristics. The model also proposes that job satisfaction is directly related to retention and indirectly related to retention though intent to stay. Individual nurse characteristics are indirectly related to retention through intent to stay. The individual characteristic of tenure is indirectly related to retention through autonomy, as an intrinsic characteristic of job satisfaction, and intent to stay. Conclusions. The proposed model can be used to guide research that explores gaps in knowledge about intent to stay and retention among home health care nurses.

The home health care industry has recently undergone tremendous change. How providers of care are adapting to the changes in their environment and the effect this has on nurses’ job satisfaction has not been explored. Nurses’ job satisfaction provides an indicator of a change in the system’s ability to deliver quality patient care and to attract and retain staff. The purpose of this study is to describe the level of job satisfaction of home health care nurses in three regions of the country. Neal’s theory of becoming a home health nurse was used as a framework for understanding the findings. Nurses in this study were satisfied with aspects of their job related to professional autonomy, relationships with patients and peers, and a sense that their work is worthwhile and important. They are less satisfied with their relationship to administration and their ability to effect changes in the system.

This paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors' previous research and additional evidence from the literature.Previous research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes.Data come from the authors' previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance.The literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing. The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes.The new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes.

Purpose:To examine the level of job satisfaction and test a theoretical model of the direct and indirect effects of job satisfaction, and individual nurse and agency characteristics, on intent to stay and retention for home healthcare nurses. Design:A descriptive correlation study of home healthcare nurses in six New England states. Methods:Home healthcare nurse job satisfaction self-report data was collected with the HHNJS survey questionnaire & Retention Survey Questionnaire. Findings:Based on a structural equation model, job tenure and job satisfaction were the strongest predictors of nurse retention. Conclusions:Understanding the variables associated with home healthcare nurse retention can help agencies retain nurses in a time of severe nurse shortages and increased patient demand. Clinical Relevance:Predicted nursing shortages and increasing demand have made the retention of experienced, qualified nursing staff essential to assure access to high-quality home healthcare services in the future.

The purpose of this study was to refine the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale (HHNJS). A theoretical model of job satisfaction had been used to develop the 30-item HHNJS, representing nine components of job satisfaction. Psychometric properties suggested the need for further refinement. Revised items and construct definitions were subjected to psychometric testing with 2,274 home healthcare nurses. Eight independent subscales consistent with the theoretical model were validated by factor analysis. Estimated internal consistency reliability of six of the eight subscales was improved. Results suggest that the refined HHNJS has potential for improving retention through accurate measurement of job satisfaction of home health care nurses.

Faced with a nursing shortage and anticipated increase in demand, home care agencies are implementing retention strategies with little knowledge of their effectiveness. The purpose of this study is to describe the strategies implemented and their effect on nurse job satisfaction and intention to leave. Data were collected from a random sample of 123 New England agencies during in-person interviews. Most agencies reported implementing multiple recruitment and retention strategies. Regression results suggest that the effects of employer retention strategy on nurses' intent to stay are the indirect result of its effects on job satisfaction. The only retention intervention that made a statistically significant difference in job satisfaction was shared governance, and no retention strategy directly affected nurses' intention to stay in their jobs.

A troubling bit of evidence recently reported by Sochalski (2004a) is that among all groups of nurses, those working in home care are among the most dissatisfied with their jobs. This is a change from the past, when nurses working in home healthcare were believed to be the most highly satisfied grou

Objectives Previous studies in mainland China found ICU nurses to be less satisfied with their jobs and more inclined to leave them than are nurses in other hospital units. We aimed to determine ICU nurses' perspectives on the factors that influence job satisfaction and whether or not to continue working in the ICU. Methods Nine ICU nurses were asked five open-ended questions to elicit the nurses' perspectives on job satisfaction and intentions to leave. Data were analyzed according to the process described by Knafl and Webster (1988). Core concepts were identified using the constant comparative method. Results Two themes emerged as major influences on job dissatisfaction: 1) stress experienced from excessive workload demands and the ICU work environment, and 2) a lack of respect and recognition for the nurses' work. Two themes emerged as major influences on job satisfaction: 1) recognition of work, and 2) professional opportunities and relationships with coworkers. The effects of job satisfaction or dissatisfaction on the nurses' intentions to leave their jobs varied, although three categories were identified. Conclusions For ICU nurses in China, sources of job dissatisfaction are potentially remedied with simple interventions. Adequate staffing is necessary but not sufficient for a positive work environment. Administrators should address the factors that directly affect their nurses' levels of job satisfaction, as it will ultimately result in less staff turnover and greater patient care.