Staying with nursing: the impact of conflictual communication, stress and organizational problem-solving

To predict nurses' intent to stay on the job as a function of organizational culture.

Organizational climate significantly contributes to retention of nurses. Communication by conflict and organizational control over problem-solving has not thoroughly been studied.

A cross-sectional design was used with a randomly selected final sample of 367 nurses from regional hospitals in Hungary. Organizational climate, perceived stress, locus of control and self-esteem were assessed as main measures. Nurses indicated their intent to stay for the next 5 years. Spearman correlation coefficients were calculated to evaluate associations. Bivariate logistic regression was performed to predict intent to stay in nursing.

Organizational climate was negatively correlated with perceived stress and personal locus of control and positively with personal self-esteem. Organizational level internal locus of control (belief that employees have control over problem-solving) doubled the probability of staying on the job. Conflictual communication and perceived stress both decreased intent to stay by 50%.

Organizational internal locus of control, stress and conflictual communication were main predictors of intent to stay. The belief that nurses had collective control over problem-solving capabilities had a positive and greater impact on nurse retention compared to other measures.

Healthcare organizations should routinely scan workplace culture for conflictual communication, stress and organizational problem-solving capacities. Graduate nurse and nurse manager training should include practices that enable developing positive work atmospheres. Hospital managements should allocate training budget to stimulate and achieve cultural change.

Nurse managers should promote internal trainings to help staff nurses adopt techniques that minimize conflict and emphasize positive impact of collaborative problem-solving.