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Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study
Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
Indian Statistical Institute, North-East Centre, India.
Stockholm University, Faculty of Social Sciences, Stress Research Institute.
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2016 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 58, 47-58 p.Article in journal (Refereed) Published
Abstract [en]

Background

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied.

Objective

The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction.

Design

Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied.

Results

Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied.

Conclusions

We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries.

Place, publisher, year, edition, pages
2016. Vol. 58, 47-58 p.
Keyword [en]
Job satisfaction, Multilevel analysis, Registered nurses, Workload
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:su:diva-128595DOI: 10.1016/j.ijnurstu.2016.02.003ISI: 000375511500006Local ID: P-3322OAI: oai:DiVA.org:su-128595DiVA: diva2:915822
Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2016-06-07Bibliographically approved

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Leineweber, ConstanzeChungkham, Holendro SinghWesterlund, Hugo
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