Emergency room nurses' pathway to turnover intention: a moderated serial mediation analysis

Area of Science:

• Nursing Research
• Organizational Psychology
• Healthcare Management

Background:

• High turnover intention among nurses is a persistent issue, particularly in emergency departments.
• Existing research often lacks a comprehensive approach, failing to integrate conceptual models or examine subgroup variations.
• Understanding the interplay of work environment, job characteristics, and psychological factors is crucial for addressing nurse retention.

Purpose of the Study:

• To investigate the associations between work environment quality, job characteristics, and demographic factors with nurse turnover intention.
• To explore the mediating roles of job satisfaction and emotional exhaustion in the relationship between work factors and turnover intention.
• To conduct subgroup analyses to identify variations in these associations among different nurse demographics.

Main Methods:

• A cross-sectional, multicentre survey was conducted with 294 nurses in 11 Belgian emergency departments (2014-2015).
• Mediation and serial mediation analyses were employed to assess indirect effects of work environment (Magnet model) and job characteristics (Job Demand Control Support model) on turnover intention.
• Moderated mediation analysis examined the consistency of these indirect effects across nurse subgroups.

Main Results:

• Specific dimensions of the Magnet model and Job Demand Control Support model were significantly associated with turnover intention, mediated by job satisfaction and emotional exhaustion.
• Social support from supervisors showed significant indirect effects on turnover intention only for female nurses, who reported higher intentions.
• Increased years of experience were associated with a lower likelihood of reporting turnover intention.

Conclusions:

• Interventions aimed at reducing turnover intention in emergency departments should focus on enhancing the work environment and job characteristics, particularly for early-career nurses.
• Targeted support for female nurses, specifically improving social support from supervisors, may be beneficial.
• Addressing these factors can contribute to improved nurse retention in high-stress emergency settings.